Patient-centered medical home care access among adults with chronic conditions: National Estimates from the medical expenditure panel survey

Almalki, Ziyad S.; Karami, Nedaa Ali; Almsoudi, Imtinan A; ALHasoun, R; Mahdi, Alaa T; Alabsi, E; Alshahrani, Saad; Alkhdhran, Nourah D; Alotaib, Tahani M

doi:10.1186/s12913-018-3554-3

Cited by 11 publications

(12 citation statements)

References 33 publications

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“…From the clinical practice perspective, it is critical to maximize efficiency for service delivery to patients with chronic NCDs such as hypertension and diabetes by adopting the patient-centered medical home (PCMH) model of care. This model is based on the same principles as the Chronic Care Model, with the primary goal of providing patients with organized, proactive, and coordinated care rather than episodic treatments to improve outcomes while also lowering management costs [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Households’ Direct Economic Burden Associated with Chronic Non-Communicable Diseases in Saudi Arabia

Almalki

Alahmari

Alqahtani

et al. 2022

IJERPH

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Households’ economic burden associated with chronic non-communicable diseases (NCDs) is a deterrent to healthcare access, adversely impacting patients’ health. Therefore, we investigated the extent of out-of-pocket (OOP) spending among individuals diagnosed with chronic NCDs among household members in Riyadh, Saudi Arabia. Face-to-face interviews were conducted among households in Riyadh Province from the beginning of January 2021 to the end of June 2021. The respondents were asked to record OOP spending throughout the past three months in their health. A generalized linear regression model was used to determine the effects of several factors on the level of OOP spending. A total of 39.6% of the households studied had at least one member with a chronic NCD. Diabetes patients spent an average of SAR 932 (USD 248), hypertension patients SAR 606 (USD 162), and hypothyroid patients SAR 402 (USD 107). It was shown that households with older and more educated members had greater OOP spending. Households with an employed head of household, more family members, higher SES status, health insurance coverage, and urban residency had significantly higher OOP expenditure. The burden of OOP spending for chronic NCD households remains high, with some disparities. The research offers important information for decision making to lower OOP cost among NCD households.

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Section: Discussionmentioning

confidence: 99%

Households’ Direct Economic Burden Associated with Chronic Non-Communicable Diseases in Saudi Arabia

Almalki

Alahmari

Alqahtani

et al. 2022

IJERPH

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“…However, pre-visit planning care is a new approach, no framework or conceptual model was introduced according to this subject. Only a planned care model was introduced by the Health Research and Quality Agency as a comprehensive patient-centered medical home (PCMH) approach in which one of its main components is pre-visit planning [ 90 , 91 ]. Hence, our findings are summarized in a conceptual model regarding applying the pre-visit assessment tool in electronic-based planned patient care (Fig.…”

Section: Discussionmentioning

confidence: 99%

Applied techniques for putting pre-visit planning in clinical practice to empower patient-centered care in the pandemic era: a systematic review and framework suggestion

Gholamzadeh

Abtahi

Ghazisaeeidi

2021

BMC Health Serv Res

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Background One of the main elements of patient-centered care is an enhancement of patient preparedness. Thus, pre-visit planning assessment tools was emerged to prepare and involve patients in their treatment process. Objective The main objective of this article was to review the applied tools and techniques for consideration of putting pre-visit planning into practice. Methods Web of Science, Scopus, IEEE, and PubMed databases were searched using keywords from January 2001 to November 2020. The review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Then, qualitative analysis was done to suggest an appropriate framework by mapping the main concepts. Results Out of 385 citations were retrieved in initial database searches, 49 studies from ten countries were included. Applied pre-visit techniques can be classified into eight categories. Our results showed that almost 81% of studies were related to procedures that were done between each visit, while 42% of articles were related to before visits. Accordingly, the main approach of included articles was patient preparedness. While 38 studies reported this approach is effective, three studies reported the effectiveness of such tools as moderate, only two articles believed it had a low effect on improving patient-centered care. Conclusion This survey summarized the characteristics of published studies on pre-visit planning in the proposed framework. This approach could enhance the quality of patient care alongside enhancement patient-provider communication. However, such an approach can also be helpful to control pandemic diseases by reducing unnecessary referrals.

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“…Research among other populations has demonstrated that those with private health insurance are significantly more likely than those with public insurance (i.e. Medicare or Medicaid) to have access to or receive care through a medical home (Almalki et al, 2018; Le et al, 2019; Zickafoose et al, 2012). In future work, it will be important to conduct prospective studies and/or consider alternative data sources that provide information about medical home status among autistic adults from across the United States.…”

Section: Discussionmentioning

confidence: 99%

Specialized primary care medical home: A positive impact on continuity of care among autistic adults

Hand

Coury

White

et al. 2020

Autism

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While the medical home has proven effective at improving continuity of care among other populations, there is a paucity of literature testing the effectiveness of medical homes in serving the healthcare needs of autistic adults. We conducted a retrospective cohort study to compare the continuity of care of autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the Center for Autism Services and Transition (CAST), to propensity score matched national samples of autistic adults with private insurance or Medicare. The unadjusted median Bice–Boxerman continuity of care index was 0.6 (interquartile range = 0.4–1.0) for CAST patients, 0.5 (interquartile range = 0.3–1.0) for Medicare beneficiaries, and 0.6 (interquartile range = 0.4–1.0) for privately insured autistic adults. In multivariable models controlling for demographic characteristics, on average, CAST patients had continuity of care indices that were 10% higher than national samples of autistic adult Medicare beneficiaries (p < 0.0001). Continuity of care among CAST patients did not significantly differ from that of the national sample of privately insured autistic adults (p = 0.08). Our findings suggest that medical homes, like CAST, may be a promising solution to improve healthcare delivery for the growing population of autistic adults. Lay abstract There is a nationally recognized need for innovative healthcare delivery models to improve care continuity for autistic adults as they age out of pediatric and into adult healthcare systems. One possible model of care delivery is called the “medical home”. The medical home is not a residential home, but a system where a patient’s healthcare is coordinated through a primary care physician to ensure necessary care is received when and where the patient needs it. We compared the continuity of care among autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the CAST, to matched national samples of autistic adults with private insurance or Medicare. Continuity of primary care among CAST patients was significantly better than that of matched national samples of autistic adult Medicare beneficiaries and similar to that of privately insured autistic adults. Our findings suggest that medical homes, like CAST, are a promising solution to improve healthcare delivery for the growing population of autistic adults.

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Patient-centered medical home care access among adults with chronic conditions: National Estimates from the medical expenditure panel survey

Cited by 11 publications

References 33 publications

Households’ Direct Economic Burden Associated with Chronic Non-Communicable Diseases in Saudi Arabia

Households’ Direct Economic Burden Associated with Chronic Non-Communicable Diseases in Saudi Arabia

Applied techniques for putting pre-visit planning in clinical practice to empower patient-centered care in the pandemic era: a systematic review and framework suggestion

Specialized primary care medical home: A positive impact on continuity of care among autistic adults

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