The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model

March 2013
AHRQ Publication No. 12(14)-0020-1-EF
Prepared For:
Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov

Contract Numbers: HHSA290200900019I/HHSA29032002T, HHSA290200900019I/HHSA29032005T
Prepared By: Mathematica Policy Research, Princeton, NJ; Aparajita Zutshi, Ph.D., Deborah Peikes, Ph.D., M.P.A., Kimberly Smith, Ph.D., M.P.A., Melissa Azur, Ph.D. (Mathematica Policy Research),  Janice Genevro, Ph.D., Michael Parchman, M.D., David Meyers, M.D. (Agency for Healthcare Research and Quality).
Table 13. Summary of evidence on caregiver experience
 Statistically SignificantInconclusive
InterventionFavorableUnfavorableNot Statistically SignificantUncertain Statistical Significance
Notes: A result is considered statistically significant if p < 0.05.

aHigh-intensity caregivers are those providing more than 14 hours per week of assistance, and low-intensity caregivers are those providing less than 14 hours per week of assistance.

Guided Carea  6 months: Caregiver burden amongall caregivers
18 months: 1 of 6 measures of caregiver experience with quality of care provided to patients among all caregivers, 4 of 6 measures among high-intensity caregivers, and 3 of 6 measures among low-intensity caregivers
18 months: Caregiver burden among all, high-intensity, and low-intensity caregivers
18 months: Caregiver productivity among all, high-intensity, and low-intensity caregivers
6 months: Caregiver burden among high-intensity caregivers
18 months: 5 of 6 measures of caregiver experience with quality of care provided to patients among all caregivers, 2 of 6 measures among high-intensity caregivers, 3 of 6 measures among low-intensity caregivers
Veterans Affairs Team-Managed Home-Based Primary Care12 months: Improved caregiver experience with quality of care provided to patients among nonterminal patients
12 months: Reduced 1 of 2 measures of caregiver burden among nonterminal patients
12 months: Improved 6 of 8 SF-36 scales among nonterminal patients
 12 months: 1 of 2 measures of caregiver burden among nonterminal patients
12 months: 2 of 8 SF-36 scales among nonterminal patients