Using Fuzzy Set Qualitative Comparative Analysis (fs/QCA) to Explore the Relationship between Medica

Authors, Primary Thygeson,Nels Marcus;Solberg,Leif I.;Asche,Stephen E.;Fontaine,Patricia;Pawlson,Leonard Gregory;Scholle,Sarah Hudson
Title Primary Using Fuzzy Set Qualitative Comparative Analysis (fs/QCA) to Explore the Relationship between Medical "Homeness" and Quality
Periodical Full Health Services Research
Pub Year 2012
Volume 47
issue 1
Start Page 22-45
Abstract OBJECTIVE: Determine, using fuzzy set qualitative comparative analysis (fs/QCA), the relationship between patient-centered medical home (PCMH) systems and quality in 21 NCQA recognized medical homes. DATA SOURCES/STUDY SETTING: Primary data collected in 2009, including measures of optimal diabetes care (ODC), preventive services up-to-date (PSUTD), patient experience (PEX), survey data assessing PCMH capabilities (PPC-RS), and other clinic characteristics. STUDY DESIGN: Cross-sectional study identifying associations between PPC-RS domains, demographic, socioeconomic, and co-morbidity measures, and quality outcomes. DATA COLLECTION/EXTRACTION METHODS: PPC-RS scores were obtained by surveying clinic leaders. PSUTD and ODC scores were obtained from provider performance data. PEX data were obtained from patient surveys. Demographic, socioeconomic, and co-morbidity data were obtained from EMR and census data. PRINCIPAL FINDINGS: fs/QCA identified associations between all three outcomes and PCMH capabilities: ODC and team-based care; PSUTD and preventive services systems; and all three outcomes and provider performance reporting systems. Previous statistical analysis of this data had failed to identify these relationships. CONCLUSIONS: fs/QCA identified important associations that were overlooked using conventional statistics in a small-N health services data set. PCMH capabilities are associated with quality outcomes.
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Reference Type(s) Journal Article
Topic Tag(s) Defining/Evaluating/Qualifying a Medical Home;Evaluation Methods and Approaches;Outcomes
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