Health Serv Res .

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United States

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van den Berk-Clark C; Doucette E; Rottnek F; Manard W; Prada MA; Hughes R; Lawrence T; Schneider FD.; van den Berk-Clark C; Doucette E; Rottnek F; Manard W; Prada MA; Hughes R; Lawrence T; Schneider FD.
2018-06 相关链接

摘要

OBJECTIVES: To examine: (1) what elements of patient-centered medical homes (PCMHs) are typically provided to low-income populations, (2) whether PCMHs improve health behaviors, experiences, and outcomes for low-income groups. DATA SOURCES/STUDY SETTING: Existing literature on PCMH utilization among health care organizations serving low-income populations. STUDY DESIGN: Systematic review and meta-analysis. DATA COLLECTION/EXTRACTION METHODS: We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving low-income populations. A total of 434 studies were reviewed. Thirty-three articles met eligibility criteria. PRINCIPAL FINDINGS: Patient-centered medical home interventions usually were composed of five of the six recommended components. Overall positive effect of PCMH interventions was d = 0.247 (range -0.965 to 1.42). PCMH patients had better clinical outcomes (d = 0.395), higher adherence (0.392), and lower utilization of emergency rooms (d = -0.248), but there were apparent limitations in study quality. CONCLUSIONS: Evidence shows that the PCMH model can increase health outcomes among low-income populations. However, limitations to quality include no assessment for confounding variables. Implications are discussed.

Patient-centered medical home; implementation; poverty; underserved patients.

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