Association of a Patient-Centered Medical Home with health care expenditures among women diagnosed with breast or cervical cancer

Introduction: A patient-centered medical home (PCMH) is associated with better quality of care and equitable care. Little is known about the impact of PCMH on costs for women diagnosed with breast or cervical cancer. The objective of the study was to determine the total health care expenditures of medical care one-year post diagnosis with breast or cervical cancer among patients who have a PCMH versus those who do not have a PCMH.

Methods: The study design is cross-sectional using pooled data and population weights from the Medical Expenditure Panel Survey (MEPS) for years 2007-2009. We identified women diagnosed with breast or cervical cancer using ICD-9 codes. We use a generalized linear model with log-gamma to study the association between total health care expenditures and a composite score of a PCMH derived from questions in MEPS related to care delivery. We adjust for individual-level potential confounds and stratify the analysis by race/ethnicity to observe differences in costs between subgroups. Results: Final results are forthcoming. Preliminary results reveal that women who receive care in a PCMH have lower total health care expenditures one-year post diagnosis with breast or cervical cancer compared to those who do not receive care in a PCMH, adjusting for all covariates. The subgroup analysis suggests that differences are greater for Hispanic and Black women.

Conclusion: Women diagnosed with breast or cervical cancer who receive care in a PCMH experience lower total health care expenditures which have implications to lower health care spending and improve equitable medical care.