Community-Level Sociodemographic Characteristics and Patient-Centered Medical Home Capacity
Population Health Management in Health Care Organizations
ISBN: 978-1-78441-197-8
Publication date: 16 October 2014
Abstract
Purpose
Longitudinally (2008–2012) assess whether community-level sociodemographic characteristics were associated with patient-centered medical home (PCMH) capacity among primary care and specialty physician practices, and the extent to which variation in PCMH capacity can be accounted for by sociodemographic characteristics of the community.
Design/methodology/approach
Linear growth curve models among 523 small and medium-sized physician practices that were members of a consortium of physician organizations pursuing the PCMH.
Findings
Our analysis indicated that the average level of sociodemographic characteristics was typically not associated with the level of PCMH capacity, but the heterogeneity of the surrounding community is generally associated with lower levels of capacity. Furthermore, these relationships differed for interpersonal and technical dimensions of the PCMH.
Implications
Our findings suggest that PCMH capabilities may not be evenly distributed across communities and raise questions about whether such distributional differences influence the PCMH’s ability to improve population health, especially the health of vulnerable populations. Such nuances highlight the challenges faced by practitioners and policy makers who advocate the continued expansion of the PCMH as a means of improving the health of local communities.
Originality/value
To date, most studies have focused cross-sectionally on practice characteristics and their association with PCMH adoption. Less understood is how physician practices’ PCMH adoption varies as a function of the sociodemographic characteristics of the community in which the practice is located, despite work that acknowledges the importance of social context in decisions about adoption and implementation that can affect the dissemination of innovations.
Keywords
Acknowledgements
Acknowledgments
This research was supported by a grant from the Agency for Healthcare Research and Quality and the University of Alabama at Birmingham’s Center for Outcomes and Effectiveness Research and Education.
Citation
Hearld, L.R., Hearld, K.R. and Hogan, T.H. (2014), "Community-Level Sociodemographic Characteristics and Patient-Centered Medical Home Capacity", Population Health Management in Health Care Organizations (Advances in Health Care Management, Vol. 16), Emerald Group Publishing Limited, Leeds, pp. 23-50. https://doi.org/10.1108/S1474-823120140000016002
Publisher
:Emerald Group Publishing Limited
Copyright © 2014 Emerald Group Publishing Limited