Integrating Population Health Strategies into Primary Care: Impact on Outcomes and Hospital Use for Low-Income Adults.
Chronic Disease
Health Disparities
Low-Income
Patient-Centered Medical Home
Population Health
Uninsured
Journal
Ethnicity & disease
ISSN: 1945-0826
Titre abrégé: Ethn Dis
Pays: United States
ID NLM: 9109034
Informations de publication
Date de publication:
2022
2022
Historique:
entrez:
2
5
2022
pubmed:
3
5
2022
medline:
4
5
2022
Statut:
epublish
Résumé
Our objectives were two-fold: 1) To evaluate the benefits of population health strategies focused on social determinants of health and integrated into the primary care medical home (PCMH) and 2) to determine how these strategies impact diabetes and cardiovascular disease outcomes among a low-income, primarily minority community. We also investigated associations between these outcomes and emergency department (ED) and inpatient (IP) use and costs. Retrospective cohort. Community-based PCMH: Baylor Scott & White Health and Wellness Center (BSW HWC). All patients who attended at least two primary care visits at BSW HWC within a 12-month time span from 2011-2015. Outcomes for patients participating in PCMH only (PCMH) as compared to PCMH plus population health services (PCMH+PoPH) were compared using electronic health record data. Diastolic and systolic blood pressure, hemoglobin A1c, ED visits and costs, and IP hospitalizations and costs were examined. From 2011-2015, 445 patients (age=46±12 years, 63% African American, 61% female, 69.5% uninsured) were included. Adjusted regression analyses indicated PCMH+PoPH had greater improvement in diabetes outcomes (prediabetes HbA1c= -.65[SE=.32], P=.04; diabetes HbA1c= -.74 [SE=.37], P<.05) and 37% lower ED costs than the PCMH group (P=.01). Worsening chronic disease risk factors was associated with 39% higher expected ED visits (P<.01), whereas improved chronic disease risk was associated with 32% fewer ED visits (P=.04). Integrating population health services into the PCMH can improve chronic disease outcomes, and impact hospital utilization and cost in un- or under-insured populations.
Identifiants
pubmed: 35497399
doi: 10.18865/ed.32.2.91
pii: ed.32.2.91
pmc: PMC9037647
doi:
Substances chimiques
Glycated Hemoglobin A
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
91-100Informations de copyright
Copyright © 2022, Ethnicity & Disease, Inc.
Déclaration de conflit d'intérêts
Competing Interests: Wesson: Paid consultant for Tricida, Inc (San Francisco) regarding metabolic acidosis (not related to this study)
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