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

Objective To estimate the effect of a patient-centered medical home (PCMH) intervention on asthma-related emergency room (ER) visits of pediatric patients. Methods Patients receiving care at pediatric primary care practices participating in the Florida Pediatric Medical Home Demonstration Project as...

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Bibliographic Details
Published in:Maternal and child health journal 2019-03, Vol.23 (3), p.369-376
Main Authors: Chakravorty, Shourjo, Knapp, Caprice A.
Format: Article
Language:English
Subjects:
Analysis
Asthma
Care and treatment
Childhood asthma
Emergency medical care
Gynecology
Logistic regression
Maternal and Child Health
Medicine
Medicine & Public Health
Patient care
Patients
Pediatric research
Pediatrics
Population Economics
Public Health
Sociology
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Summary:Objective To estimate the effect of a patient-centered medical home (PCMH) intervention on asthma-related emergency room (ER) visits of pediatric patients. Methods Patients receiving care at pediatric primary care practices participating in the Florida Pediatric Medical Home Demonstration Project as well as pediatric patients treated at non-participating clinics were identified from 4 years of claims and enrollment data. We estimate several fixed effects logistic regression models using one pre-treatment year and three post-treatment years to investigate whether asthma-related ER visits decreased because of the PCMH intervention. Results The estimation suggests that the intervention did have a negative effect on asthma-related ER visits in the earlier part of the intervention (OR 0.34; 95% CI 0.16–0.73). However, this effect was not detected in the later years. Because fixed effects models require repeated observations on the same individual, we believe our estimations of the PCMH model’s impact is more accurate than previous studies. Conclusion for Practice Reducing asthma ER visits is a task that might be immediately actionable for PCMH practices, or those undergoing transformation. Our results adds to the others suggesting positive impacts of the PCMH.
ISSN:1092-7875
1573-6628
DOI:10.1007/s10995-018-2661-4