title: Higher Referrals for Diabetes Education in a Medical Home Model of Care.
abstract: The medical home model has been gaining attention from the health care community as a strategy for improved outcomes for management of chronic disease, including diabetes. The purpose of this study was to compare referrals for diabetes education among patients receiving care from a medical home model versus a traditional practice.
  
  
  
  Data were obtained from a large, university-affiliated primary care patient data registry. All patients (age 18-96 years) with a diagnosis of prediabetes or diabetes and seen by a physician at least twice during 2011 to 2013 were selected for inclusion. Multivariate regression models measuring the association between medical home status and referral to diabetes education were computed before and after adjusting for covariates.
  
  
  
  A significantly (P < .001) higher percentage of patients in a medical home than without a medical home (23.9% vs 13.5%) received a referral for diabetes education. After adjusting for covariates, medical home patients were 2.7 times more likely to receive a referral for diabetes education (odds ratio, 2.70; 95% confidence interval, 1.69-4.35).
  
  
  
  Patients in a medical home model were more likely to receive referrals for diabetes education than patients in a standard university-affiliated family medicine practice. Future longitudinal designs that match characteristics of patients with a medical home with those of patients without one will provide strong evidence to determine whether referral to diabetes education is a result of the medical home model of care independent of confounding factors.
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine (WTM, JSa, FDS, DH-A, JSc); the Center for Outcomes Research, Saint Louis University School of Medicine (KS, AB, EA); the Department of Pharmacy Practice, Division of Ambulatory Care, Saint Louis College of Pharmacy, Saint Louis University School of Medicine (EC).
authors.forename: William T
authors.initials: WT
authors.lastname: Manard
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine (WTM, JSa, FDS, DH-A, JSc); the Center for Outcomes Research, Saint Louis University School of Medicine (KS, AB, EA); the Department of Pharmacy Practice, Division of Ambulatory Care, Saint Louis College of Pharmacy, Saint Louis University School of Medicine (EC).
authors.forename: Kevin
authors.initials: K
authors.lastname: Syberg
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine (WTM, JSa, FDS, DH-A, JSc); the Center for Outcomes Research, Saint Louis University School of Medicine (KS, AB, EA); the Department of Pharmacy Practice, Division of Ambulatory Care, Saint Louis College of Pharmacy, Saint Louis University School of Medicine (EC).
authors.forename: Anit
authors.initials: A
authors.lastname: Behera
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine (WTM, JSa, FDS, DH-A, JSc); the Center for Outcomes Research, Saint Louis University School of Medicine (KS, AB, EA); the Department of Pharmacy Practice, Division of Ambulatory Care, Saint Louis College of Pharmacy, Saint Louis University School of Medicine (EC).
authors.forename: Joanne
authors.initials: J
authors.lastname: Salas
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine (WTM, JSa, FDS, DH-A, JSc); the Center for Outcomes Research, Saint Louis University School of Medicine (KS, AB, EA); the Department of Pharmacy Practice, Division of Ambulatory Care, Saint Louis College of Pharmacy, Saint Louis University School of Medicine (EC).
authors.forename: F David
authors.initials: FD
authors.lastname: Schneider
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine (WTM, JSa, FDS, DH-A, JSc); the Center for Outcomes Research, Saint Louis University School of Medicine (KS, AB, EA); the Department of Pharmacy Practice, Division of Ambulatory Care, Saint Louis College of Pharmacy, Saint Louis University School of Medicine (EC).
authors.forename: Eric
authors.initials: E
authors.lastname: Armbrecht
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine (WTM, JSa, FDS, DH-A, JSc); the Center for Outcomes Research, Saint Louis University School of Medicine (KS, AB, EA); the Department of Pharmacy Practice, Division of Ambulatory Care, Saint Louis College of Pharmacy, Saint Louis University School of Medicine (EC).
authors.forename: Denise
authors.initials: D
authors.lastname: Hooks-Anderson
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine (WTM, JSa, FDS, DH-A, JSc); the Center for Outcomes Research, Saint Louis University School of Medicine (KS, AB, EA); the Department of Pharmacy Practice, Division of Ambulatory Care, Saint Louis College of Pharmacy, Saint Louis University School of Medicine (EC).
authors.forename: Erica
authors.initials: E
authors.lastname: Crannage
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine (WTM, JSa, FDS, DH-A, JSc); the Center for Outcomes Research, Saint Louis University School of Medicine (KS, AB, EA); the Department of Pharmacy Practice, Division of Ambulatory Care, Saint Louis College of Pharmacy, Saint Louis University School of Medicine (EC). scherrjf@slu.edu.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Scherrer
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000628:therapy*; D005194:Family Practice / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: Diabetes Mellitus; Education; Medical Home; Patient