Hypertensive patients' specialty use changed with medical home

Group Health studied how patients with treated hypertension used outpatient specialty care before, during, and after a primary-care redesign (the patient-centered medical home) was spread system-wide. David T. Liss, PhD, now a research assistant professor in medicine-general internal medicine and geriatrics at Northwestern University Feinberg School of Medicine, led the report in the Journal of General Internal Medicine.

"Redesigning care to a medical home seems to let primary-care teams do more, within their expertise, for their patients," Dr. Liss said. "Our results suggest this can avoid or prevent some specialty visits for patients with stablehypertension and a few co-occurring illnesses." He studied more than 36,000 patients with treated hypertension in Group Health's 26 medical centers.

Patients with hypertension and few other conditions had 27-28 percent fewer specialty visits in each of the three years after the medical home started being implemented, compared to beforehand, adjusting for potential confounders and including interaction effects. Those with some other illnesses had 9 percent fewer specialty visits during medical home implementation and 5 percent fewer specialty visits during the following year.