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VOLUME 53 | NUMBER 3 | JUNE 2018

Do PatientCentered Medical Homes Improve Health Behaviors, Outcomes, and Experiences of LowIncome Patients? A Systematic Review and MetaAnalysis

Objectives: To examine: (1) what elements of patientcentered medical homes (PCMHs) are typically provided to lowincome populations, (2) whether PCMHs improve health behaviors, experiences, and outcomes for lowincome groups.

Data Sources/Study Setting: Existing literature on PCMH utilization among health care organizations serving lowincome populations.

Study Design: Systematic review and metaanalysis.

Data Collection/Extraction Methods: We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving lowincome populations. A total of 434 studies were reviewed. Thirtythree articles met eligibility criteria.

Principal Findings: Patientcentered medical home interventions usually were composed of five of the six recommended components. Overall positive effect of PCMH interventions was d = 0.247 (range −0.965 to 1.42). PCMH patients had better clinical outcomes (d = 0.395), higher adherence (0.392), and lower utilization of emergency rooms (d = −0.248), but there were apparent limitations in study quality.

Conclusions: Evidence shows that the PCMH model can increase health outcomes among lowincome populations. However, limitations to quality include no assessment for confounding variables. Implications are discussed.

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