Maeng Daniel Dukjae, Sciandra Joann P, Tomcavage Janet F
Geisinger Health System, Danville, PA, USA.
Risk Manag Healthc Policy. 2016 May 26;9:67-74. doi: 10.2147/RMHP.S102826. eCollection 2016.
The impact of a patient-centered medical home (PCMH) in reducing total cost of care remains a subject of debate, particularly among the non-elderly adult population. This study examines a 6-year experience of a large integrated regional health care delivery system in the US implementing PCMH among its commercially insured population. A regional health plan's claims data from 2008 through 2013 among its commercially insured members were obtained and analyzed. Over the 6-year period, the PCMH implementation beyond the first 6 months of exposure was associated with a lower total cost of care of ∼9% (P<0.05). The largest reduction was observed in outpatient costs (12%; P<0.05). This study suggests that PCMH implementation among the non-elderly adult population can potentially lead to cost savings. Future studies are necessary to identify the drivers of the cost savings and examine if similar results can be replicated elsewhere by other health care delivery systems.
以患者为中心的医疗之家（PCMH）在降低医疗总费用方面的影响仍是一个有争议的话题，尤其是在非老年成年人群体中。本研究考察了美国一个大型综合区域医疗保健提供系统在其商业保险人群中实施PCMH的6年经验。获取并分析了一个区域健康计划在2008年至2013年期间其商业保险成员的理赔数据。在这6年期间，实施PCMH超过最初暴露的6个月后，医疗总费用降低了约9%（P<0.05）。门诊费用降幅最大（12%；P<0.05）。这项研究表明，在非老年成年人群体中实施PCMH可能会带来成本节约。未来有必要开展研究，以确定成本节约的驱动因素，并考察其他医疗保健提供系统能否在其他地方复制类似结果。
