1173-P: Use of Patient-Centered Medical Homes (PCMH)–Related Care Management Processes to Improve Glycemic Control in Medicaid Patients and Non-Medicaid Patients

Background: Care management processes are meant to improve care quality, but there is little information about their effectiveness in socioeconomically disadvantaged individuals. This study was aimed to test if systematic care management processes are as effective in controlling diabetes among Medic...

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Veröffentlicht in:Diabetes (New York, N.Y.) N.Y.), 2020-06, Vol.69 (Supplement_1)
Hauptverfasser: FU, HELEN N., WOLFSON, JULIAN, SOLBERG, LEIF, GREY, MARGARET, PETERSON, KEVIN A.
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Sprache:eng
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Zusammenfassung:Background: Care management processes are meant to improve care quality, but there is little information about their effectiveness in socioeconomically disadvantaged individuals. This study was aimed to test if systematic care management processes are as effective in controlling diabetes among Medicaid as in non-Medicaid patients. Methods: This cross-sectional study used standardized performance measures (glycemic control, BP control, statin drug use, aspirin use, smoking cessation) matched to a 2017- clinic survey on the use of diabetes-related care management processes (62 items in Physician Practice Connections-Research Survey). A mixed effect multi-level regression model with fixed clinic- and patient-level independent variables and random clinic-level intercepts was used to test the association between clinic use of care management processes (index of 0-100%) and glycemic control of glycated hemoglobin (A1C) level while adjusting for patient covariates (age, sex, comorbid conditions, diabetes type 1 or 2, residence rurality) and clinic covariates (PCMH certification, medical group size, federally qualified health center). Results: The overall mean index of care-management processes usage was 86% (IQR of 76-97%). Every 10% increase in the use of care management processes was associated with a decrease of 0.57 in A1C (p
ISSN:0012-1797
1939-327X
DOI:10.2337/db20-1173-P