Does a Large-Scale Organizational Transformation Toward Patient-Centered Access Change the Utilizati

Authors, Primary Grembowski,David;Anderson,Melissa L.;Ralston,James D.;Martin,Diane P.;Reid,Robert
Title Primary Does a Large-Scale Organizational Transformation Toward Patient-Centered Access Change the Utilization and Costs of Care for Patients With Diabetes?
Periodical Full Medical Care Research and Review
Pub Year 2012
Volume 69
issue 5
Start Page 619-39
Abstract The authors examined whether Group Health's Access Initiative changed the utilization and costs of care among enrollees with diabetes. Using a single (one-group) interrupted time series design, repeated-measures generalized estimating equation models were used to estimate changes in utilization and costs during the Initiative rollout (2002-2003) and to compare the slopes (annual rates of change) for utilization and costs during the Pre-Initiative period (1998-2002) to the slopes during Full-Implementation (2003-2006) among 9,871 members continuously enrolled from 1997 to 2006 with type 1 or 2 diabetes. Total costs increased in Full-Implementation, but the annual change in total costs did not change. Primary care visits declined, but primary care contacts grew, largely from the Initiative's introduction of secure messaging. Specialty visits did not change; however, the Initiative may have increased emergency visits. To reduce emergency visits, future access initiatives should include proactive and comprehensive outpatient care for patients with diabetes.
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Reference Type(s) Journal Article
Topic Tag(s) Access to Care;Cost and Reimbursement
Special Population(s) Individuals with Multiple Chronic Conditions
Case Study No
Commentary/Opinion Piece No
Historical Publication No
Key/Foundational Article No
Literature Review No
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