title: Is Access to and Use of Patient Perceived Patient-Centered Medical Homes Associated With Reduced Nonurgent Emergency Department Use?
abstract: This study examined whether access to and use of patient-centered medical home (PCMH) practices is associated with reduced nonurgent emergency department (ED) use, especially among the uninsured population. This retrospective study used 2010-2011 Medical Expenditure Panel Survey data. Difference-in-difference methods, multivariate logit model, marginal effect, and survey procedures were employed. A total of 1287 adults had any ED visit in 2011, which represented weighted 29 463 684 people in the population. Reductions in odds of nonurgent ED use between the full PCMH group and the "no regular provider" group was significantly larger for the uninsured group than publicly and privately insured groups (β = -1.70, P = .009, and β = -1.04, P = .040, respectively). Similar results were found between the partial PCMH group and the "no regular provider" group for the uninsured group compared to the public group (β = -1.67, P = .019). PCMH models demonstrate higher odds of reduced nonurgent ED use among uninsured individuals compared to public and private enrollees nationwide.
authors.affiliation: 1 University of Alabama at Birmingham, AL.
authors.forename: Haichang
authors.initials: H
authors.lastname: Xin
authors.affiliation: 1 University of Alabama at Birmingham, AL.
authors.forename: Meredith L
authors.initials: ML
authors.lastname: Kilgore
authors.affiliation: 1 University of Alabama at Birmingham, AL.
authors.forename: Bisakha
authors.initials: B
authors.lastname: Sen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008483:Medical Assistance / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
keywords: PCMH; nationwide; nonurgent emergency department use