title: Medical Home Characteristics and Quality of Diabetes Care in Safety Net Clinics.
abstract: We examined associations between patient-centered medical home (PCMH) characteristics and quality of diabetes care in 15 safety net clinics in five states. Surveys among clinic directors assessed PCMH characteristics using the Safety Net Medical Home Scale. Chart audits among 864 patients assessed diabetes process and outcome measures. We modeled the odds of the patient receiving performance measures as a function of total PCMH score and of PCMH subscales and covariates. PCMH characteristics had mixed, inconsistent associations with the quality of diabetes care. The PCMH model may require refinement in design and implementation to improve diabetes care among vulnerable populations.
authors.affiliation: Section of General Internal Medicine, Department of Medicine, University of Chicago, 5841 S. Maryland Ave., MC2007, Chicago, IL, 60637, USA. kgunter@medicine.bsd.uchicago.edu.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Gunter
authors.affiliation: Department of Public Health Sciences and Section of General Internal Medicine, Department of Medicine, University of Chicago, 5841 S. Maryland Ave., MC2007, Chicago, IL, 60637, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Nocon
authors.affiliation: Section of General Internal Medicine, Department of Medicine, University of Chicago, 5841 S. Maryland Ave., MC2007, Chicago, IL, 60637, USA.
authors.forename: Yue
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, 402 E. 67th Street, New York, NY, 10065-6304, USA.
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Casalino
authors.affiliation: Section of General Internal Medicine, Department of Medicine, University of Chicago, 5841 S. Maryland Ave., MC2007, Chicago, IL, 60637, USA.
authors.forename: Marshall H
authors.initials: MH
authors.lastname: Chin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D064876:Safety-net Providers / Q000458:organization & administration* / Q000592:standards; D014481:United States; D055815:Young Adult
keywords: Diabetes; Patient-centered medical home; Primary care; Quality; Safety net