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Patient-centered medical homes and preventive service use
Joel F Farley1, Arun Kumar, Benjamin Y Urick
1University of Minnesota College of Pharmacy, 7-159D Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455.
The American Journal of Managed Care
|May 24, 2019
Summary
Having a usual source of care (USC) increases preventive screening rates. Patient-centered medical home (PCMH) status showed fewer benefits, suggesting access to a USC is crucial for preventive care.
Area of Science:
- Health Services Research
- Preventive Medicine
- Primary Care
Background:
- Patient-centered medical homes (PCMHs) are hypothesized to improve preventive service utilization.
- Limited nationally representative data exist on the impact of PCMHs on preventive care.
- Understanding the role of a usual source of care (USC) is essential for optimizing preventive service delivery.
Purpose of the Study:
- To compare preventive service use between patients with and without a USC.
- To examine differences in preventive service use among patients with a USC based on PCMH certification status.
Main Methods:
- Cross-sectional study using the 2015 Medical Expenditure Panel Survey.
- Constructed preventive service indicators for general and disease-specific screenings.
- Utilized multivariable logistic regression to compare screening rates between groups, controlling for relevant covariates.
Main Results:
- Patients with a USC had higher odds of breast cancer screening (OR=2.40) and cervical cancer screening (OR=1.99).
- Diabetes patients with a USC showed higher odds of annual eye exams (OR=2.05).
- Among those with a USC, PCMH certification was linked to higher foot screenings (OR=2.01) but lower cholesterol screenings (OR=0.30).
Conclusions:
- A usual source of care is associated with increased utilization of several preventive screenings.
- The impact of PCMH status on preventive screening was less pronounced than having a USC.
- Enhancing access to a usual source of care may be as critical as implementing PCMH principles for improving preventive care.
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