Abstract

Patient Centered Medical Home (PCMH) is a health care model implemented in all United States Air Force (USAF) medical facilities which uses a team-based approach to promote accessibility, quality care, and appropriate service utilization, while decreasing costs. To measure the effectiveness of this model, the National Committee for Quality Assurance (NCQA) has developed a tool to document and recognize facilities that incorporate all model elements. However, the effects of the full model implementation on patient outcomes in military settings have not been studied. This research fills an important gap in the literature because it studies the effect of PCMH implementation in military settings, which has been mandated by the Assistant Secretary of the Defense. The five-phase implementation plan for PCMH in the USAF was described in the first manuscript. The second manuscript specifically identifies the hypotheses studied, the methods for data collection and analysis, and provides a synthesis of results. This study evaluates the effects of PCMH implementation on patients with type-2 diabetes (T2DM) in military clinics. This study also explores whether NCQA Provider Practice Connections-Patient Centered Medical Home (PPC-PCMH) recognition scores, based upon the standards of the PCMH, explain variations in glycated hemoglobin levels (HgA1c), emergency department (ED) visits, and hospitalized days among T2DM patients. The results show support for the effect of PCMH implementation on HgA1c for patients with T2DM seen in military clinics. Support was mixed for PCMH having a positive effect on hospitalized days and ED visits. Evidence was not found for the ability of NCQA PPC-PCMH recognition to explain variation in HgA1c.

Date of publication

Spring 5-6-2013

Document Type

Dissertation

Language

english

Persistent identifier

http://hdl.handle.net/10950/108

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