Patient-Centered Medical Home and its Associations with Healthcare Utilization and Expenditures
Open AccessObjectives: Continually increasing U.S. healthcare costs have heavily burdened society. To mitigate this situation, the patient-centered medical home (PCMH) has been highly promoted, but existing findings on PCMH were inconsistent. This study, therefore, examined the certified PCMH (versus non-PCMH) and its associations with healthcare utilization and expenditures.Data Source and Study Setting: This study used the Medical Expenditure Panel Survey and Medical Organizations Survey data. The population with multiple chronic conditions (MCC) was selected because chronic conditions have continually been a concern due to their heavy influence on rapidly increased healthcare utilization and expenditures. As the theoretical framework, the Andersen model was used to apply three factors: predisposing, enabling, and healthcare needs. Study Design: This study applied a retrospective observational cross-sectional analysis. Since some healthcare utilization and expenditure dependent variables have large proportions of zeros, a two-part analysis was employed using the hurdle model and two-part model. Principal Findings: The results showed some significant associations between having a certified PCMH (versus a non-PCMH) and decreased prescribed medicine purchases (3.60 times less) for the population with MCC; no significant associations existed for prescribed medicine expenditures from total payment sources and the out-of-pocket payment source. Other results showed no statistically significant differences. Conclusions: This research confirmed findings from existing literature that the PCMH model has decreased associations with prescribed medicine purchases. Additional policy efforts should be made regarding PCMHs, especially with the purchase and management of prescribed medications. Providing more benefits while controlling expenditures is especially important when considering future policy drives to support the implementation and expansion of PCMHs.
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