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Do Patient‐Centered Medical Homes Improve Health Behaviors, Outcomes, and Experiences of Low‐Income Patients? A Systematic Review and Meta‐Analysis
Author(s) -
BerkClark Carissa,
Doucette Emily,
Rottnek Fred,
Manard William,
Prada Mayra Aragon,
Hughes Rachel,
Lawrence Tyler,
Schneider F. David
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12737
Subject(s) - medical home , psychological intervention , medicine , data extraction , meta analysis , medline , confounding , systematic review , health care , family medicine , gerontology , environmental health , nursing , primary care , pathology , political science , law , economics , economic growth
Objectives To examine: (1) what elements of patient‐centered medical homes ( PCMH s) are typically provided to low‐income populations, (2) whether PCMH s improve health behaviors, experiences, and outcomes for low‐income groups. Data Sources/Study Setting Existing literature on PCMH utilization among health care organizations serving low‐income populations. Study Design Systematic review and meta‐analysis. Data Collection/Extraction Methods We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving low‐income populations. A total of 434 studies were reviewed. Thirty‐three articles met eligibility criteria. Principal Findings Patient‐centered medical home interventions usually were composed of five of the six recommended components. Overall positive effect of PCMH interventions was d = 0.247 (range −0.965 to 1.42). PCMH patients had better clinical outcomes ( d = 0.395), higher adherence (0.392), and lower utilization of emergency rooms ( d = −0.248), but there were apparent limitations in study quality. Conclusions Evidence shows that the PCMH model can increase health outcomes among low‐income populations. However, limitations to quality include no assessment for confounding variables. Implications are discussed.