Comparison of Proportions of Quality Measures Met at Baseline and During the Intervention Period Between Those Seen in the Expanded Medical Home (Ypsilanti Health Center/Regional Alliance for Healthy Schools) versus Those Seen Only at Their Primary Care Physician's Office (Ypsilanti Health Center Only)*
| Quality Measure | Baseline (September 1, 2013, through August 31, 2014) | Intervention (September 1, 2014, through June 30, 2015) | Differences in Improvements Between Groups,† % (P Value) | ||||
|---|---|---|---|---|---|---|---|
| YHC/RAHS | YHC Only | Difference in Patients Meeting Metric, % (P Value) | YHC/RAHS | YHC Only | Difference in Patients Meeting Metric, % (P Value) | ||
| Asthma Action Plan | 65.0 (13/20) | 46.0 (46/100) | 19 (.19) | 92.3 (24/26) | 77.2 (71/92) | 15.1 (.10)‡ | −3.9 (.78) |
| Influenza vaccination | |||||||
| Patients with asthma | 58.6 (17/29) | 62.0 (93/150) | −3.4 (.89) | 73.5 (25/34) | 55.6 (69/124) | 17.9 (.09) | 21.3 (.11) |
| All patients | 57.8 (111/192) | 48.4 (619/1279) | 9.4% (.02) | 58.8 (141/240) | 49.4 (511/1035) | 9.4 (.01) | 0 (.99) |
| Nutrition/physical activity counseling§ | 48.5 (50/103) | 14.8 (75/508) | 33.7 (<.001) | 53.8 (63/117) | 19.1 (74/387) | 34.7 (<.001) | 1 (.90) |
| Spirometry for patients with asthma | 48.3 (14/29) | 46.0 (69/150) | 2.3 (.98) | 61.8 (21/34) | 43.5 (54/124) | 18.3 (.09) | 16 (.25) |
| Well-child visit | 71.4 (137/192) | 65.6 (839/1279) | 5.8 (.14) | 77.1 (185/240) | 69.9 (723/1035) | 7.2 (.03) | 1.4 (.75) |
Data are % (n/N) unless otherwise indicate. Bold values indicate statistically significant difference.
↵* The baseline time period was 12 months and the intervention time period was 10 months. Comparisons are made using the χ2 test unless otherwise stated.
↵† Difference in between-group differences was determined using a z-test. An overall measure of the effect that the expanded medical home had on the likelihood of receiving the recommended services was evaluated through logistic regression with a binary indicator for receiving the service as the outcome and group (Ypsilanti Health Center [YHC]/Regional Alliance for Healthy Schools [RAHS] vs YHC only), time, and service type as covariates. Patients seen in the expanded medical home had a higher likelihood of receiving quality metric services than patients seen in the YHC only (odds ratio, 1.8; 95% confidence interval, 1.57–2.05) across all measures.
↵‡ Comparison via Fisher exact test.
↵§ For patients with a body mass index within or above the 85th percentile.