WEDNESDAY, June 27, 2007 (HealthDay News) -- Patients, particularly minority patients, who have a regular doctor receive better care and have better health outcomes, a new report finds.
Providing minority patients with a "medical home" -- where they have a regular doctor who oversees and coordinates their care -- may help eliminate racial disparities in health care and "promote more health-care equity," according to a survey released Wednesday from the Commonwealth Fund.
"There are still disparities in access to health care," said co-author Dr. Anne Beal, a senior program officer at the Commonwealth Fund, a private, nonpartisan foundation that supports independent research on health and social issues. "There is a difference on whether you have insurance or not in terms of access to care, preventive care and chronic disease management."
"What we did find, however, is that people who had enhanced access to a primary-care provider through a 'medical home' had no disparities in care," Beal added. "This is one of the first studies to demonstrate a promising model for trying to address health-care disparities."
Patients have a "medical home" when they have a regular health-care provider or place of care, have no difficulty contacting a provider by phone, have no difficulty getting advice or medical care when needed on weekends or evenings, and find office visits well-organized and efficiently run, Beal explained.
Minorities with a "medical home" receive the same quality of care as other patients, Beal said. "This is a very promising model for improving health care for everybody, but particularly for a vulnerable patient population," she noted.
However, a "medical home" is not common for most Americans. Only 15 percent of Hispanics report having one, compared with 28 percent of whites, 34 percent of blacks and 26 percent of Asian-Americans, according to the report.
The report was compiled using data from phone interviews with 2,837 U.S. adults who were predominately black, Hispanic and Asian.
When people have a "medical home," health outcomes are better, Beal said, adding that a regular provider improves preventive care, chronic care and overall heath care.
For instance, the survey found that:
- Adults with a "medical home" are better prepared to manage chronic conditions such as diabetes or hypertension. Only 23 percent of adults with a "medical home" said their doctor or doctor's office did not give them a plan to manage their care at home, compared with 65 percent who have no regular source of care.
- Forty-two percent of hypertensive adults with a "medical home" reported that they check their blood pressure and it is well-controlled, compared with 25 percent without a "medical home."
Beal noted that health insurance -- or a lack of it -- is a key factor in whether a patient has a "medical home." The uninsured were much less likely to have one, she said.
Beal thinks that expanding the concept of a "medical home" could help alleviate racial disparities in medical care in the United States. "We should promote this concept for all kinds of providers, whether we are talking about private doctors, community health centers, or other types of providers," she said.
And these programs should be supported by Medicare, Medicaid and private health insurance companies, Beal said. "Patients who have this enhanced access are less likely to go to the emergency room and be hospitalized," she said.
One expert agreed that having a "medical home" improves health care.
"The notion that people need to have a regular physician is absolutely right," said Greg Scandlen, founder of Consumers for Health Care Choices, an advocacy group for consumers and patients. "That is really missing in American health care right now. The way we do primary care in America is terrible."
Scandlen added that the concept of a "medical home" could be expanded beyond the doctor's office. "One of the things we have been saying in consumer-driven health care is that consumers need to have an agent that will help them navigate the health-care system," he said. "Ideally that agent would be their personal physician."
More information
To learn more, visit The Commonwealth Fund.
