Do Patient‐Centered Medical Homes Improve Health Behaviors, Outcomes, and Experiences of Low‐Income Patients? A Systematic Review and Meta‐Analysis
Published online on July 03, 2017
Abstract
Objectives
To examine: (1) what elements of patient‐centered medical homes (PCMHs) are typically provided to low‐income populations, (2) whether PCMHs improve health behaviors, experiences, and outcomes for low‐income groups.
Data Sources/Study Setting
Existing literature on PCMH utilization among health care organizations serving low‐income populations.
Study Design
Systematic review and meta‐analysis.
Data Collection/Extraction Methods
We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving low‐income populations. A total of 434 studies were reviewed. Thirty‐three articles met eligibility criteria.
Principal Findings
Patient‐centered medical home interventions usually were composed of five of the six recommended components. Overall positive effect of PCMH interventions was d = 0.247 (range −0.965 to 1.42). PCMH patients had better clinical outcomes (d = 0.395), higher adherence (0.392), and lower utilization of emergency rooms (d = −0.248), but there were apparent limitations in study quality.
Conclusions
Evidence shows that the PCMH model can increase health outcomes among low‐income populations. However, limitations to quality include no assessment for confounding variables. Implications are discussed.