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The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model | PCMH Resource Center
in this review. … From a literature search, we identified 14 evaluations of 12 interventions that met our inclusion criteria … In many cases, because of the limited information that study authors can include in a journal article … reported improvements in processes of care, and two of three reported improvements in some measures … : a systematic review of congestive heart failure. -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 11 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … The effects reported here are point estimates; the true effects can lie anywhere within the confidence … We do not include the confidence intervals because not all studies reported them. a Because the statistical … account, we made this adjustment by using ICC estimates from the literature. … estimates of the intracluster correlation (ICC) from the literature. -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 10 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … The effects reported here are point estimates; the true effects can lie anywhere within the confidence … We do not include the confidence intervals because not all studies reported them. a Because the statistical … account, we made this adjustment by using ICC estimates from the literature. … estimates of the intracluster correlation (ICC) from the literature. -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Appendix | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … the published and grey literature on the PCMH in the United States. … We used the EBSCO search engine on the following databases: Academic Search Premier, Business Source … Corporate, Cumulative Index to Nursing and Allied Health Literature, Cochrane Center Register of Controlled … In many cases, because of the limits on what study authors can include in a journal article, we sought -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 9 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … The effects reported here are point estimates; the true can lie anywhere within confidence intervals … We do not include the confidence intervals because not all studies reported them. a We adjusted the p-values … for clustering for findings on costs for the GRACE evaluation using a range of estimates of the intracluster … correlation (ICC) from the literature. -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 17 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … case managers make home visits Random chart reviews to assess adherence to case management protocols; review … been hospitalized or using skilled nursing facility services; the team conducts a home visit and full review … GCN, study team, and nurse managers met monthly to review performance No payment component. … The DCS and psychiatrist review progress weekly over the year-long intervention No payment component -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 8 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Summary of evidence on mortality Statistically Significant Inconclusive Intervention Favorable Unfavorable … Statistical significance is considered uncertain if the study did not account for clustering of patients … patients with diabetes 2 years: Patients with diabetes Geriatric Resources for Assessment and Care of -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 14 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Summary of evidence on professional experience Statistically Significant Inconclusive Intervention … Guided Care 12 months: Satisfaction with care management, time spent on chronic care, knowledge of … and knowledge of patients’ clinical circumstance -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 5 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Number of evaluations that assessed each triple aim outcome and health care professional experience … of Care Processes of Care 7 3 Health Outcomes 4 3 Mortality 2 2 Cost and Service Use Costs … or without the Intervention) 11 4 Hospital Use 12 5 Emergency Department Use 9 3 Experience of -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 12 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Summary of evidence on patient experience Statistically Significant Inconclusive Intervention Favorable … Guided Care 1.5 years: Decision support 1.5 years: Care coordination, overall quality of care, goal … Year 1: Improved access to care, interpersonal experience, technical quality, communication, and self-reported -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 6 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Summary of evidence on processes of care Statistically Significant Inconclusive Intervention Favorable … of antidepressant use, psychotherapy 1.5 years; 2 years: Increased rates of antidepressant use 1 Year … : 2 process of care measures 1.5 years ; 2 years : Rates of psychotherapy 1 Year : 16 process of care -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 16 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … To receive a high rating, RCTs that meet all thesecriteria also need to control for any reported baseline … confounding factors, no endogenous subgroups, no samplereassignment, and low attrition at the unit of … No systematic confounding factors, but with (1) endogenous subgroups, (2) highattrition of the analysis -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 7 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Geriatric Resources for Assessment and Care of Elders 2 years: Improved 4 of 8 Short Form (SF)-36 scales … 2 years: 4 of 8 SF-36 scales, Activities of Daily Living (ADLs), Instrumental Activities of Daily … 1 year: Barthel index and 7 of 8 SF-36 scales for nonterminal patients -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 13 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Guided Care a 6 months: Caregiver burden amongall caregivers 18 months: 1 of 6 measures of caregiver … 6 measures of caregiver experience with quality of care provided to patients among all caregivers, 2 … care provided to patients among nonterminal patients 12 months: Reduced 1 of 2 measures of caregiver … 12 months: 1 of 2 measures of caregiver burden among nonterminal patients 12 months: 2 of 8 SF-36 -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 15 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Snapshot of findings Statistically Significant Inconclusive Intervention Favorable Unfavorable Not … Statistically Significant Uncertain Statistical Significance Processes of Care Geriatric Resources for … Assessment and Care of Elders Yes Yes Care Management Plus Yes Yes Improving Mood–Promoting -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 1 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Community Care of North Carolina Community-based care management provided through networks of primary … care physicians (PCPs), a hospital, the Department of Social Services, and the health department. … Department of Veterans Affairs, 2007; Hughes, Weaver, Giobbie-Hurder, et al., 2000. -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 3 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Evaluation designs and outcomes of the 12 interventions Cost and Service Use Quality of Care … Health outcomes include measures of functioning, quality of life, and self-rated health status. … Processes of care include measures such as proportion of patients with controlled blood pressure, or -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 2 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Target Population Implementation Setting Intervention Name Target Population (and Consent Rate When Reported … primary care practices in networks not reported) Many Geisinger Health System ProvenHealth Navigator … dysthymia Yes Yes 450 primary care providers in primary care clinics operating in IDSs (mostly academic -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 4.2 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … : Outcome Primary Rationale Aetna’s Embedded Case Managers Unknown Excluded: Hospital use; process of … care; health care professional experience Limited information on design and analysis reported Community … North Carolina (Evaluation 3) Unknown Excluded: Costs Limited information on design and analysis reported -
The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 4.1 | PCMH Resource Center
A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model March … at followup and no reported statistically significant baseline differences in the outcomes Low: 1 of … care outcomes; caregiver experience of care outcomes RCT with low attrition and no reported statistically … outcomes; patient experience of care at 3 and 12 months; costs RCT with low attrition and no reported … attrition and no reported statistically significant baseline differences in the outcomes Low: For subgroup