Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use
Background. Between 1995 and 1998, tribally owned Southcentral Foundation (SCF) incrementally assumed responsibility from the Indian Health Service (IHS) for primary care services on the Alaska Native Medical Center (ANMC) campus in Anchorage, Alaska. In 1999, SCF began implementing components of a...
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Online Access: | https://doi.org/10.3402/ijch.v72i0.20960 https://doaj.org/article/9f544478f61145feb08c974a6850e0c9 |
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ftdoajarticles:oai:doaj.org/article:9f544478f61145feb08c974a6850e0c9 2023-05-15T15:14:23+02:00 Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use Janet M. Johnston Julia J. Smith Vanessa Y. Hiratsuka Denise A. Dillard Quenna N. Szafran David L. Driscoll 2013-08-01T00:00:00Z https://doi.org/10.3402/ijch.v72i0.20960 https://doaj.org/article/9f544478f61145feb08c974a6850e0c9 EN eng Taylor & Francis Group http://www.circumpolarhealthjournal.net/index.php/ijch/article/download/20960/pdf_1 https://doaj.org/toc/2242-3982 doi:10.3402/ijch.v72i0.20960 2242-3982 https://doaj.org/article/9f544478f61145feb08c974a6850e0c9 International Journal of Circumpolar Health, Vol 72, Iss 0, Pp 1-7 (2013) Patient-Centered Medical Home Alaska Native asthma inpatient hospitalization time series analysis Arctic medicine. Tropical medicine RC955-962 article 2013 ftdoajarticles https://doi.org/10.3402/ijch.v72i0.20960 2022-12-31T00:16:12Z Background. Between 1995 and 1998, tribally owned Southcentral Foundation (SCF) incrementally assumed responsibility from the Indian Health Service (IHS) for primary care services on the Alaska Native Medical Center (ANMC) campus in Anchorage, Alaska. In 1999, SCF began implementing components of a Patient-Centered Medical Home (PCMH) model to improve access and continuity of care. Objective. To evaluate hospitalisation trends before, during and after PCMH implementation. Design. Time series analysis of aggregated medical record data. Methods. Regression analysis with correlated errors was used to estimate trends over time for the percent of customer-owners hospitalised overall and for specific conditions during 4 time periods (March 1996–July 1999: SCF assumes responsibility for primary care; August 1999–July 2000: PCMH implementation starts; August 2000–April 2005: early post-PCMH implementation; May 2005–December 2009: later post-PCMH implementation). Analysis was restricted to individuals residing in Southcentral Alaska and receiving health care at ANMC. Results. The percent of SCF customer-owners hospitalised per month for any reason was steady before and during PCMH implementation, declined steadily immediately following implementation and subsequently stabilised. The percent hospitalised per month for unintentional injury or poisoning also declined during and after the PCMH implementation. Among adult asthma patients, the percent hospitalised annually for asthma declined prior to and during implementation and remained lower thereafter. The percent of heart failure patients hospitalised annually for heart failure remained relatively constant throughout the study period while the percent of hypertension patients hospitalised for hypertension shifted higher between 1999 and 2002 compared to earlier and later years. Conclusion. Implementation of PCMH at SCF was accompanied by decreases in the percent of customer-owners hospitalised monthly for any reason and for ... Article in Journal/Newspaper Arctic Circumpolar Health International Journal of Circumpolar Health Alaska Directory of Open Access Journals: DOAJ Articles Anchorage Arctic Indian International Journal of Circumpolar Health 72 1 20960 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Patient-Centered Medical Home Alaska Native asthma inpatient hospitalization time series analysis Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Patient-Centered Medical Home Alaska Native asthma inpatient hospitalization time series analysis Arctic medicine. Tropical medicine RC955-962 Janet M. Johnston Julia J. Smith Vanessa Y. Hiratsuka Denise A. Dillard Quenna N. Szafran David L. Driscoll Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use |
topic_facet |
Patient-Centered Medical Home Alaska Native asthma inpatient hospitalization time series analysis Arctic medicine. Tropical medicine RC955-962 |
description |
Background. Between 1995 and 1998, tribally owned Southcentral Foundation (SCF) incrementally assumed responsibility from the Indian Health Service (IHS) for primary care services on the Alaska Native Medical Center (ANMC) campus in Anchorage, Alaska. In 1999, SCF began implementing components of a Patient-Centered Medical Home (PCMH) model to improve access and continuity of care. Objective. To evaluate hospitalisation trends before, during and after PCMH implementation. Design. Time series analysis of aggregated medical record data. Methods. Regression analysis with correlated errors was used to estimate trends over time for the percent of customer-owners hospitalised overall and for specific conditions during 4 time periods (March 1996–July 1999: SCF assumes responsibility for primary care; August 1999–July 2000: PCMH implementation starts; August 2000–April 2005: early post-PCMH implementation; May 2005–December 2009: later post-PCMH implementation). Analysis was restricted to individuals residing in Southcentral Alaska and receiving health care at ANMC. Results. The percent of SCF customer-owners hospitalised per month for any reason was steady before and during PCMH implementation, declined steadily immediately following implementation and subsequently stabilised. The percent hospitalised per month for unintentional injury or poisoning also declined during and after the PCMH implementation. Among adult asthma patients, the percent hospitalised annually for asthma declined prior to and during implementation and remained lower thereafter. The percent of heart failure patients hospitalised annually for heart failure remained relatively constant throughout the study period while the percent of hypertension patients hospitalised for hypertension shifted higher between 1999 and 2002 compared to earlier and later years. Conclusion. Implementation of PCMH at SCF was accompanied by decreases in the percent of customer-owners hospitalised monthly for any reason and for ... |
format |
Article in Journal/Newspaper |
author |
Janet M. Johnston Julia J. Smith Vanessa Y. Hiratsuka Denise A. Dillard Quenna N. Szafran David L. Driscoll |
author_facet |
Janet M. Johnston Julia J. Smith Vanessa Y. Hiratsuka Denise A. Dillard Quenna N. Szafran David L. Driscoll |
author_sort |
Janet M. Johnston |
title |
Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use |
title_short |
Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use |
title_full |
Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use |
title_fullStr |
Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use |
title_full_unstemmed |
Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use |
title_sort |
tribal implementation of a patient-centred medical home model in alaska accompanied by decreased hospital use |
publisher |
Taylor & Francis Group |
publishDate |
2013 |
url |
https://doi.org/10.3402/ijch.v72i0.20960 https://doaj.org/article/9f544478f61145feb08c974a6850e0c9 |
geographic |
Anchorage Arctic Indian |
geographic_facet |
Anchorage Arctic Indian |
genre |
Arctic Circumpolar Health International Journal of Circumpolar Health Alaska |
genre_facet |
Arctic Circumpolar Health International Journal of Circumpolar Health Alaska |
op_source |
International Journal of Circumpolar Health, Vol 72, Iss 0, Pp 1-7 (2013) |
op_relation |
http://www.circumpolarhealthjournal.net/index.php/ijch/article/download/20960/pdf_1 https://doaj.org/toc/2242-3982 doi:10.3402/ijch.v72i0.20960 2242-3982 https://doaj.org/article/9f544478f61145feb08c974a6850e0c9 |
op_doi |
https://doi.org/10.3402/ijch.v72i0.20960 |
container_title |
International Journal of Circumpolar Health |
container_volume |
72 |
container_issue |
1 |
container_start_page |
20960 |
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1766344839178223616 |