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首页> 外文期刊>Journal of primary care & community health. >Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida
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Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida

机译：初步转型对佛罗里达州联邦合格的医疗中心糖尿病成果的患者为中心的医疗房屋的影响

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Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care. The study objective was to examine the effects of initial transformation to a level 3 National Committee for Quality Assurance (NCQA) certified PCMH in 2011, on clinical diabetes outcomes among 27 clinic sites from a network of FQHCs in Florida. We used de-identified, longitudinal electronic health record (EHR) data from 2010-2012 and multivariate logistic regression to analyze the effects of initial transformation on the odds of having well-controlled HbA1c, body mass index (BMI), and blood pressure (BP) among vulnerable patients with diabetes. Models controlled for clustering by year, patient, and organizational characteristics. Overall, transformation to a PCMH was associated with 19% greater odds of having well-controlled HbA1c values with no statistically significant impact on BMI or BP. Subanalyses showed transformation had less of an effect on BP for African American patients and HbA1c control for Medicare enrollees but a greater effect on weight control for patients older than 35 years. Transformation to a PCMH in FQHCs appears to improve the health of vulnerable patients with diabetes, with less improvement for subsets of patients. Future research should seek to understand the heterogeneous effects of patient-centered transformation on various subgroups.
机译：佛罗里达州的联邦合格的健康中心（FQCS）看到大量脆弱患者糖尿病患者。以患者为中心的医疗家庭（PCMH）模型可导致慢性条件患者的健康状况和供应商的成本节约。因此，FQCS越来越多地移动到PCMH的护理模型。研究目标是审查2011年初步转型对3级国家质量保证委员会（NCQA）认证的PCMH委员会的影响，来自佛罗里达州FQHCS网络中的27个临床部位中的临床糖尿病成果。我们使用2010 - 2012年的De-Identified，纵向电子健康记录（EHR）数据和多变量逻辑回归，分析初始转化对具有良好控制的HBA1C，体重指数（BMI）和血压的影响的影响（ BP）弱势患者患有糖尿病患者。按年，患者和组织特征控制的模型。总体而言，对PCMH的转化与患有良好控制的HBA1C值的次数增加了19％，对BMI或BP没有统计学显着的影响。 SubanAlyses表现出转型对非洲裔美国患者和HBA1C对Medicare Rearlees的患者的影响较少，而是对35岁的患者的体重控制效果更大。在FQCS中转化为PCMH，似乎改善了患有糖尿病患者的健康，对患者亚群的改善较少。未来的研究应该寻求了解患者中心转型对各种亚组的异质效果。

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