Over the past decade, how patients receive their care in clinics has been transforming, from traditional primary care to patient-centered medical homes. These "homes" focus on team-based, coordinated, and whole-person care instead of short-term, episodic, or fragmented care seen earlier in primary care. While research has shown patient-centered medical homes can lead to improved care, University of Minnesota researchers set out to discover why that might be the case.
"Although we can look for whether changes to clinics are responsible for better outcomes, we need to know how those improvements might happen," said Nathan Shippee, an assistant professor in the Division of Health Policy and Management in the School of Public Health.
Using data provided by MN Community Measurement, researchers looked at how being certified as a patient-centered medical home by the state of Minnesota—part of the state's Health Care Home initiative—helped patients get better asthma care, compared to other primary care clinics.
"With asthma care, we had measures that allowed us to break down the quality of care into different pieces and test the relationship between clinic organization, care management and patient education, and health outcomes. This helps us understand how—and not just whether—we might obtain better outcomes in Health Care Home clinics," said Shippee.
The researchers' study, published in the American Journal of Managed Care, shows that Health Care Homes had better asthma outcomes than other primary care clinics, and that asthma care management (patient education with an asthma action plan) made up a sizable piece of that. The study found that better rates of asthma education with an action plan made up 16- to 35-percent of the total Health Care Home clinics' benefit for asthma health outcomes. However, most of the benefit of Health Care Homes was due to other factors.
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Assessing Medical Home Mechanisms: Certification, Asthma Education, and Outcomes American Journal of Managed Care. www.ajmc.com/journals/issue/20 … ucation-and-outcomes