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The Impact of the Patient-Centered Medical Home on Asthma-Related Visits to the Emergency Room: A Fixed Effects

Shourjo Chakravorty1, Caprice A Knapp2

  • 1Department of Economics, Istanbul Technical University, İşletme Fakültesi, Ekonomi Bölömü, Maçka, Istanbul, 34367, Turkey. chakravorty@itu.edu.tr.

Maternal and Child Health Journal
|December 16, 2018
PubMed

Insights

The patient-centered medical home (PCMH) intervention initially reduced pediatric asthma emergency room (ER) visits. However, this positive effect on asthma ER visits diminished over time.

Area of Science:

  • Health Services Research
  • Pediatric Primary Care
  • Chronic Disease Management

Background:

  • Asthma is a leading cause of pediatric emergency room (ER) visits, contributing significantly to healthcare costs and burden.
  • Patient-centered medical homes (PCMH) aim to improve care coordination and patient outcomes, but their impact on specific conditions like pediatric asthma requires further investigation.

Purpose of the Study:

  • To evaluate the effect of a patient-centered medical home (PCMH) intervention on asthma-related emergency room (ER) visits among pediatric patients.
  • To determine if PCMH implementation leads to a reduction in asthma-related ER utilization in pediatric primary care settings.

Main Methods:

  • Utilized claims and enrollment data from pediatric patients over four years, including one pre-treatment and three post-treatment years.
  • Employed fixed effects logistic regression models to analyze the impact of the PCMH intervention on asthma-related ER visits.
  • Compared outcomes for patients in PCMH-participating clinics versus non-participating clinics.

Main Results:

  • The PCMH intervention demonstrated a statistically significant negative effect on asthma-related ER visits in the initial period post-implementation (OR 0.34; 95% CI 0.16-0.73).
  • This beneficial effect on reducing asthma ER visits was not sustained in the later years of the study period.
  • Fixed effects modeling provided robust estimations due to repeated individual observations, enhancing accuracy compared to prior studies.

Conclusions:

  • The patient-centered medical home (PCMH) model shows potential for immediate impact in reducing pediatric asthma ER visits.
  • Practices undergoing transformation into a PCMH may find it an actionable strategy to decrease asthma-related ER utilization.
  • Findings contribute to the growing body of evidence supporting the positive impacts of the PCMH model on healthcare outcomes.

Keywords:
AsthmaEmergency roomPatient-centered medical homePediatric

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