title: Primary care medical home experience and health-related quality of life among adult medicaid patients with type 2 diabetes.
abstract: OBJECTIVE
  To examine whether patient-reported indicators of medical home performance are associated with health-related quality of life (HRQOL) among adults with type 2 diabetes.
  
  
  METHODS
  Cross-sectional survey of 540 patients with Medicaid insurance and type 2 diabetes in Los Angeles County. The Primary Care Assessment Tool was used to measure seven features of medical home performance. The EuroQol EQ-5D-3L (EQ-5D) was used to measure HRQOL.
  
  
  RESULTS
  Higher total medical home performance was correlated with better overall HRQOL. A one-point change in total medical home score was associated with a 0.06-point higher score on the EQ-5D index [95 % confidence interval (CI): 0.01-0.11], which is a clinically meaningful difference. The total score was also significantly associated with a lower likelihood of problems on one domain of the EQ-5D (pain). Longitudinality was the only medical home feature associated with better general health status (ordered odds ratio = 1.78; 95 % CI: 1.04-3.03). The positive relationship of medical home with the EQ-5D appears to be present predominantly among women.
  
  
  CONCLUSIONS
  Overall medical home experience is favorably associated with HRQOL among vulnerable adult patients with type 2 diabetes. Provider efforts to improve the overall medical home experience for patients may contribute to improvements in HRQOL.
authors.affiliation: Departments of Family Medicine and Preventive Medicine, Keck School of Medicine of the University of Southern California, 1000 South Fremont Ave, Unit #80, Los Angeles, CA, USA, gstevens@usc.edu.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Stevens
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
authors.forename: Christina
authors.initials: C
authors.lastname: Vane
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Nie
authors.forename: Anne L
authors.initials: AL
authors.lastname: Peters
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008484:Medicaid / Q000592:standards; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods* / Q000592:standards; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D011788:Quality of Life / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult