TitleFacilitating primary care provider use in a patient-centered medical home intervention study for chronic hemodialysis patients.
Publication TypeJournal Article
Year of Publication2018
AuthorsChukwudozie, IBeverly, Fitzgibbon, ML, Schiffer, L, Berbaum, M, Gilmartin, C, David, P, Ekpo, E, Fischer, MJ, Porter, AC, Aziz-Bradley, A, Hynes, DM
JournalTransl Behav Med
Volume8
Issue3
Pagination341-350
Date Published2018 May 23
ISSN1613-9860
Abstract
 

Patients with chronic kidney disease have a high disease burand may benefit from primary care services and care coord A medical home model with direct access to primary care services is one approach that may address this need, yet has not been examined. As a substudy of the Patient-Centered Outcomes Research Institute (PCORI) patient-centered medical home for kidney disease (PCMH-KD) health system intervention study, we examined the uptake of free primary care physician (PCP) services. The PCORI PCMH-KD study was an initial step toward integrating PCPs, a nurse coordinator, a pharmacist, and community health workers (CHWs) within the health care delivery team. Adult chronic hemodialysis (CHD) at two urban dialysis centers were enrolled in the intervention. We examined trends and factors associated with the use of the PCMH-KD PCP among two groups of patients based on their report of having a regular physician for at least six months (established-PCP) or not (no-PCP). Of the 173 enrolled patients, 91 (53%) patients had at least one visit with the PCMH-KD PCP. The rate of visits was higher in those in the no-PCP group compared with those in the established-PCP group (62% vs. 41%, respectively). Having more visits with the CHW was positively associated with having a visit with the PCMH-KD PCPs for both groups. Embedded CHWs within the care team played a role in facilithe uptake of PCMH-KD PCP. Lessons from this health system intervention can inform future approaches on the integration of PCPs and care coordination for CHD patients.

DOI10.1093/tbm/iby021
Alternate JournalTransl Behav Med
PubMed ID29800412