Flottemesch Thomas J, Fontaine Patricia, Asche Stephen E, Solberg Leif I
HealthPartners Research Foundation, Minneapolis, Minnesota 55440-1524, USA.
J Ambul Care Manage. 2011 Jan-Mar;34(1):78-89. doi: 10.1097/JAC.0b013e3181ff6fd2.
Multilevel, multivariate models examined the relationship between Primary Care Medical Home (PCMH) practice systems as measured by the Physician Practice Connections®-Readiness Survey™ (PPC®-RS™) and costs (total, outpatient, and inpatient) using 2008 patient data from 21 primary care clinics. Overall, PPC-RS scores were associated with insignificant changes in total (-$75/person, 1.1%) outpatient (-$67/person, 1.2%), and inpatient ($68/person, 0.5%) costs. However, improved PPC-RS scores were associated with significant decreases in total ($2378, 4.4%) and outpatient ($1282/person, 3.5%) costs among patients with 11 or more prescriptions suggesting higher functioning PCMHs may lead to reduced costs among the most complex and costly patients.
多层次多变量模型使用来自21家初级保健诊所的2008年患者数据,研究了通过医师实践联系-准备情况调查(PPC-RS)衡量的初级保健医疗之家(PCMH)实践系统与成本(总计、门诊和住院)之间的关系。总体而言,PPC-RS得分与总计(-75美元/人,1.1%)、门诊(-67美元/人,1.2%)和住院(68美元/人,0.5%)成本的微小变化相关。然而,在有11种或更多处方的患者中,PPC-RS得分的提高与总计成本(2378美元,4.4%)和门诊成本(1282美元/人,3.5%)的显著降低相关,这表明功能更强的PCMHs可能会降低最复杂且成本最高的患者的费用。