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以患者为中心的医疗之家模式:非老年精神疾病患者的医疗服务利用和成本。

The patient-centered medical home model: healthcare services utilization and cost for non-elderly adults with mental illness.

机构信息

a Health Policy and Management, School of Public Health and Health Sciences, University of Massachusetts Amherst , Amherst , MA , USA.

b School of Public Health and Health Sciences, University of Massachusetts Amherst , Amherst , MA , USA.

出版信息

J Ment Health. 2018 Dec;27(6):574-582. doi: 10.1080/09638237.2017.1385744. Epub 2017 Oct 9.

Abstract

BACKGROUND

The patient-centered medical home (PCMH) model is designed to improve health outcomes while containing the cost of care. However, the evidence is inconclusive.

AIMS

The aim of this study was to examine the associations between receipt of care consistent with the PCMH and healthcare services utilization and expenditures for non-elderly adults with mental illness in the USA.

METHOD

A surveillance study was conducted using self-reported data for 6908 non-elderly adults with mental illness participating in the 2007-2012 Medical Expenditure Panel Survey. Healthcare services utilization and expenditures were compared for study participants who received care consistent with the PCMH, participants with a non-PCMH usual source of care (USC), and participants without a USC.

RESULTS

Differences in utilization and expenditures between participants who received care consistent with the PCMH and participants who had a non-PCMH USC were not statistically significant for any healthcare services category.

CONCLUSIONS

Receipt of care consistent with the PCMH was not significantly associated with differences in healthcare services utilization or expenditures compared to having a non-PCMH USC. Research assessing whether the PCMH is cost-effective for non-elderly adults with mental illness is needed.

摘要

背景

以患者为中心的医疗之家(PCMH)模式旨在改善健康结果,同时控制医疗成本。然而,证据尚无定论。

目的

本研究旨在检验美国患有精神疾病的非老年成年人接受符合 PCMH 的医疗服务与医疗服务利用和支出之间的关联。

方法

使用自我报告的数据,对参加 2007-2012 年医疗支出调查的 6908 名患有精神疾病的非老年成年人进行了一项监测研究。比较了符合 PCMH 的医疗服务接受者、非 PCMH 常规医疗服务提供者(USC)的参与者和没有 USC 的参与者的医疗服务利用和支出。

结果

在任何医疗服务类别中,接受符合 PCMH 的医疗服务与接受非 PCMH USC 的参与者之间的利用和支出差异在统计学上没有显著性。

结论

与拥有非 PCMH USC 相比,接受符合 PCMH 的医疗服务与医疗服务利用或支出的差异没有显著关联。需要研究评估 PCMH 对患有精神疾病的非老年成年人是否具有成本效益。

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