Primary Submission Category: Health care/services
Patient-Centered Medical Home Programs and Hospital Readmissions: Evidence and Insights from Community Engagement
Authors: Xiao Li, Jae Man Park, Jialing Zhu,
Presenting Author: Xiao Li*
INTRODUCTION
The Patient-Centered Medical Home (PCMH) model is a transformative approach to primary care that emphasizes patient-centered, team-based, and coordinated services. Prior research demonstrates that PCMH implementation enhances patient experience and care quality; however, limited studies explore the mechanisms through which these improvements occur. This study examines the mediating role of physician communication in the relationship between PCMH services and hospital readmissions for Chronic Obstructive Pulmonary Disease (COPD) and Heart Failure (HF).
METHODS
We utilized a national sample of 1,073 U.S. acute care hospitals, integrating data from multiple nationwide sources. Our data of independent variable (PCMH services) and covariates (hospital characteristics) were from 2019, while our mediator (physician communication ratings) and dependent variable (30-day unplanned readmissions for COPD and HF) span from 2020 to 2023. Structural Equation Modeling was employed to assess the mediation pathway and quantify the indirect effects of PCMH services on hospital readmissions.
PRELIMINARY RESULTS RESULT/IMPLICATIONS
Our results suggest that PCMH services had a marginally positive effect on physician communication ratings in the first year (2020) and a stronger, more sustained positive effect in the following years (2021–2023). Higher physician communication ratings were marginally associated with lower COPD readmission rates and strongly associated with lower HF readmissions. However, there was no strong statistical evidence that physician communication ratings served as a mediator between PCMH services and hospital readmissions, though the directional trend suggests a potential negative effect. Our findings suggest that PCMH services improve physician communication over time. However, while physician communication is important for patient care, its mediating effect on hospital readmissions remains uncertain. Future research should investigate specific PCMH components, such as care coordination, discharge planning, and post-acute follow-up, contribute to reducing hospital readmissions and identify the underlying mechanisms driving these effects.
References are available upon request