title: Impact of the medical home model on the quality of primary care: the Belgian experience.
abstract: BACKGROUND
  The Belgium medical home (MH) model, which has been garnering support of late, resembles its US counterpart in that it aims at improving the quality of health care while containing costs.
  
  
  OBJECTIVE
  To compare the quality of care offered by MHs with that offered by traditional individual practices (IPs) in Belgium in terms of the extent of their adherence to clinical practice guidelines in antibiotherapy, cervical-cancer screening, influenza vaccination, and the management of diabetes.
  
  
  METHODS
  This is a retrospective study using public insurance claims data. Data consisted of a random sample of patients using the services of MHs and IPs who were previously matched according to sex, age category, location, disability, and socioeconomic status. We applied the McNemar test, the t test, or the Wilcoxon test, depending on the type of variable being compared.
  
  
  METHODS
  The final sample comprised 43,678 patients in the year 2004.
  
  
  METHODS
  On the basis of a review of the literature, we selected 4 themes, corresponding to 25 indicators: antibiotherapy, cervical-cancer screening, influenza vaccination, and the management of diabetes.
  
  
  RESULTS
  MHs were more likely than IPs to adhere to evidence-based clinical practice guidelines. They prescribed less and more appropriate antibiotherapy, provided wider influenza-vaccination coverage for target groups, and provided a better follow-up for diabetics than did IPs. In regard to cervical-cancer screening, no significant differences were found.
  
  
  CONCLUSIONS
  MHs, as they combine a greater adherence to guidelines and savings in secondary care, are a cost-effective alternative to traditional IPs and therefore should be encouraged.
authors: *School of Public Health, Université Libre de Bruxelles, Brussels, Belgium †Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal ‡Faculté de Santé Publique, Université catholique de Louvain, Brussels, Belgium §Department of Public Health, Faculty of Medicine, Ghent University, Ghent, Belgium ∥Fédération des Maisons Médicales, Brussels, Belgium.
authors: Catherine
authors: C
authors: Moureaux
authors: Julian
authors: J
authors: Perelman
authors: Elise
authors: E
authors: Mendes da Costa
authors: Isabelle
authors: I
authors: Roch
authors: Lieven
authors: L
authors: Annemans
authors: Isabelle
authors: I
authors: Heymans
authors: Marie-Christine
authors: MC
authors: Closon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001530:Belgium; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000628:therapy; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000458:organization & administration*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D007252:Influenza Vaccines