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Using Fuzzy Set Qualitative Comparative Analysis (fs/ QCA ) to Explore the Relationship between Medical “Homeness” and Quality
Author(s) -
Marcus Thygeson Nels,
Solberg Leif I.,
Asche Stephen E.,
Fontaine Patricia,
Gregory Pawlson Leonard,
Scholle Sarah Hudson
Publication year - 2012
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/j.1475-6773.2011.01303.x
Subject(s) - qualitative comparative analysis , medicine , socioeconomic status , medical home , quality (philosophy) , family medicine , data set , qualitative property , data collection , health care , census , data mining , primary care , computer science , statistics , environmental health , population , philosophy , mathematics , epistemology , economics , economic growth , machine learning , artificial intelligence
Objective Determine, using fuzzy set qualitative comparative analysis (fs/ QCA ), the relationship between patient‐centered medical home ( PCMH ) systems and quality in 21 NCQA recognized medical homes. Data Sources/Study Setting Primary data collected in 2009, including measures of optimal diabetes care ( ODC ), preventive services up‐to‐date ( PSUTD ), patient experience ( PEX ), survey data assessing PCMH capabilities ( PPC ‐ RS ), and other clinic characteristics. Study Design Cross‐sectional study identifying associations between PPC ‐ RS domains, demographic, socioeconomic, and co‐morbidity measures, and quality outcomes. Data Collection/Extraction Methods PPC‐RS scores were obtained by surveying clinic leaders. PSUTD and ODC scores were obtained from provider performance data. PEX data were obtained from patient surveys. Demographic, socioeconomic, and co‐morbidity data were obtained from EMR and census data. Principal Findings fs/ QCA identified associations between all three outcomes and PCMH capabilities: ODC and team‐based care; PSUTD and preventive services systems; and all three outcomes and provider performance reporting systems. Previous statistical analysis of this data had failed to identify these relationships. Conclusions fs/ QCA identified important associations that were overlooked using conventional statistics in a small‐N health services data set. PCMH capabilities are associated with quality outcomes.