@article{4303678,
  abstract     = {{Background: The medical home (MH) model has prompted increasing attention given its potential to improve quality of care while reducing health expenditures.
Objectives: We compare overall and specific health care expenditures in Belgium, from the third-party payer perspective (compulsory social insurance), between patients treated at individual practices (IP) and at MHs. We compare the sociodemographic profile of MH and IP users.
Research Design: This is a retrospective study using public insurance claims data. Generalized linear models estimate the impact on health expenditures of being treated at a MH versus IP, controlling for individual, and area-based sociodemographic characteristics. The choice of primary care setting is modeled using logistic regressions.
Subjects: A random sample of 43,678 persons followed during the year 2004. 
Measures: Third-party payer expenditures for primary care, secondary care consultations, pharmaceuticals, laboratory tests, acute and long-term inpatient care.
Results: Overall third-party payer expenditures do not differ significantly between MH and IP users ((sic)+27). Third-party payer primary care expenditures are higher for MH than for IP users ((sic)+129), but this difference is offset by lower expenditures for secondary care consultations ((sic)-11), drugs ((sic)-40), laboratory tests ((sic)-5) and acute and long-term inpatient care ((sic)-53). MHs attract younger and more underprivileged populations.
Conclusions: MHs induce a shift in expenditures from secondary care, drugs, and laboratory tests to primary care, while treating a less economically favored population. Combined with positive results regarding quality, MH structures are a promising way to tackle the challenges of primary care.}},
  author       = {{Perelman, Julian and Roch, Isabelle and Heymans, Isabelle and Moureaux, Catherine and Lagasse, Raphael and Annemans, Lieven and Closon, Marie-Christine}},
  issn         = {{0025-7079}},
  journal      = {{MEDICAL CARE}},
  keywords     = {{health care expenditures,socioeconomic characteristics,PHYSICIAN,FINANCIAL INCENTIVES,primary care,medical home}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{682--688}},
  title        = {{Medical homes versus individual practice in primary care impact on health care expenditures}},
  url          = {{http://doi.org/10.1097/MLR.0b013e318293c2df}},
  volume       = {{51}},
  year         = {{2013}},
}

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