PMID- 29161972
OWN - NLM
STAT- MEDLINE
DCOM- 20180205
LR  - 20221207
IS  - 2150-1327 (Electronic)
IS  - 2150-1319 (Print)
IS  - 2150-1319 (Linking)
VI  - 8
IP  - 4
DP  - 2017 Oct
TI  - Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes 
      Outcomes in Federally Qualified Health Centers in Florida.
PG  - 192-197
LID - 10.1177/2150131917742300 [doi]
AB  - OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
FAU - Kinsell, Heidi S
AU  - Kinsell HS
AD  - 1 Florida State University, Tallahassee, FL, USA.
FAU - Hall, Allyson G
AU  - Hall AG
AD  - 2 University of Alabama at Birmingham, Birmingham, AL, USA.
FAU - Harman, Jeffrey S
AU  - Harman JS
AD  - 1 Florida State University, Tallahassee, FL, USA.
FAU - Tewary, Sweta
AU  - Tewary S
AD  - 3 Nova Southeastern University, Ft Lauderdale, FL, USA.
FAU - Brickman, Andrew
AU  - Brickman A
AD  - 4 Health Choice Network of Florida, Miami, FL, USA.
LA  - eng
PT  - Journal Article
DEP - 20171121
PL  - United States
TA  - J Prim Care Community Health
JT  - Journal of primary care & community health
JID - 101518419
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Adult
MH  - Black or African American
MH  - Age Factors
MH  - Aged
MH  - Blood Preservation
MH  - Body Mass Index
MH  - Community Health Centers/*organization & administration
MH  - Delivery of Health Care/*organization & administration
MH  - Diabetes Mellitus/metabolism/*therapy
MH  - Female
MH  - Florida
MH  - Glycated Hemoglobin/metabolism
MH  - Hispanic or Latino
MH  - Humans
MH  - Logistic Models
MH  - Longitudinal Studies
MH  - Male
MH  - Medicare
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Outcome Assessment, Health Care
MH  - Patient-Centered Care/*organization & administration
MH  - Quality of Health Care
MH  - United States
MH  - Vulnerable Populations
MH  - White People
PMC - PMC5932745
OTO - NOTNLM
OT  - access to care
OT  - community health centers
OT  - disease management
OT  - health outcomes
OT  - impact evaluation
OT  - patient-centeredness
OT  - primary care
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2017/11/23 06:00
MHDA- 2018/02/06 06:00
PMCR- 2017/11/21
CRDT- 2017/11/23 06:00
PHST- 2017/11/23 06:00 [pubmed]
PHST- 2018/02/06 06:00 [medline]
PHST- 2017/11/23 06:00 [entrez]
PHST- 2017/11/21 00:00 [pmc-release]
AID - 10.1177_2150131917742300 [pii]
AID - 10.1177/2150131917742300 [doi]
PST - ppublish
SO  - J Prim Care Community Health. 2017 Oct;8(4):192-197. doi: 
      10.1177/2150131917742300. Epub 2017 Nov 21.