Observational studyHealth services research2018
The Reduction in ED and Hospital Admissions in Medical Home Practices Is Specific to Primary Care-Sensitive Chronic Conditions.
Observational study in Health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Dimensions and components of hospital-at-home care: a systematic review.BMC health services research · 2024Pooled it
- The role of family health centres in preventing paediatric emergency department usage of parents of children with non-urgent conditions.BMC primary care · 2024Article
- Changes in emergency department visits and mortality during the COVID-19 pandemic: a retrospective analysis of 956 hospitals.Archives of public health = Archives belges de sante publique · 2024Article
- The identification of clusters of risk factors and their association with hospitalizations or emergency department visits in home health care.Journal of advanced nursing · 2023Article
- Article
- Impact of an addiction medicine consult team intervention in a Canadian inner city hospital on acute care utilization: a pragmatic quasi-experimental study.Substance abuse treatment, prevention, and policy · 2022Article
- Cohort study of team-based care among marginalized people who use drugs in Ottawa.Canadian family physician Medecin de famille canadien · 2022Article
- Requirements for Creating a Position for Community Health Nursing Within the Iranian Primary Health Care System: A SWOT Analysis.Frontiers in public health · 2021Article
- An implementation history of primary health care transformation: Alberta's primary care networks and the people, time and culture of change.BMC family practice · 2020Article
- Integrating nurse practitioners into primary care: policy considerations from a Canadian province.BMC family practice · 2020Article
- Disparities in Emergency Department Visits Among Collocated Racial/Ethnic Medicare Enrollees.Annals of emergency medicine · 2019Article
- A Novel Curriculum for Internal Medicine Residents to Care for High-Need, High-Cost Patients.Journal of medical education and curricular developmentArticle
- Reducing Acute Hospitalizations at High-Performing CPC+ Primary Care Practice Sites: Strategies, Activities, and Facilitators.Annals of family medicineArticle
- Factors Associated With Patient-Centered Medical Home Teams' Use of Resources for Identifying and Approaches for Managing Patients With Complex Needs.The Journal of ambulatory care managementArticle
- Impact of Team-Based Care on Emergency Department Use.Annals of family medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectiveTo determine whether the Patient-Centered Medical Home (PCMH) transformation reduces hospital and ED utilization, and whether the effect is specific to chronic conditions targeted for management by the PCMH in our setting. DATA SOURCES AND STUDY
settingAll patients aged 18 years and older in 2,218 primary care practices participating in a statewide PCMH incentive program sponsored by Blue Cross Blue Shield of Michigan (BCBSM) in 2009-2012. STUDY
designQuantitative observational study, jointly modeling PCMH-targeted versus other hospital admissions and ED visits on PCMH score, patient, and practice characteristics in a hierarchical multivariate model using the generalized gamma distribution. DATA COLLECTION: Claims data and PCMH scores held by BCBSM. PRINCIPAL
findingsBoth hospital and ED utilization were reduced proportionately to PCMH score. Hospital utilization was reduced by 13.9 percent for PCMH-targeted conditions versus only 3.8 percent for other conditions (p = .003), and ED utilization by 11.2 percent versus 3.7 percent (p = .010). Hospital PMPM cost was reduced by 17.2 percent for PCMH-targeted conditions versus only 3.1 percent for other conditions (p < .001), and ED PMPM cost by 9.4 percent versus 3.6 percent (p < .001).
conclusionsPCMH transformation reduces hospital and ED use, and the majority of the effect is specific to PCMH-targeted conditions.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.