Social justice in health: the patient-centered medical home and health disparities
Description
TitleSocial justice in health: the patient-centered medical home and health disparities
Date Created2021
Other Date2021-01 (degree)
Extent1 online resource (xii, 212 pages)
DescriptionCurrently, the United States healthcare system is inequitable. It facilitates health disparities in the incidence, prevalence, mortality, and burden of disease among specific populations. These populations face inequities such as reduced healthcare access, lack of culturally competent care, discrimination, and poorer health outcomes. Despite the efforts of both Federally Qualified Health Centers (FQHCs) and the Patient-Centered Medical Home (PCMH) model, health disparities persist. There is currently no empirical evidence that the PCMH can reduce health disparities in populations impacted by health inequities.
Guided by a constructivist perspective, this study utilized a convergent parallel mixed-methods design to examine the efficacy of the PCMH model in reducing health disparities in FQHCs. Four research questions were addressed: 1) Does the NCQA PCMH improve physical and mental health among low-income minority populations, particularly patients with diabetes, hypertension, coronary artery disease, obesity, and risk for depression in New Jersey? 2) What has been the patient experience in NCQA PCMH-recognized health centers serving low-income, minority groups in New Jersey? 3) What has been the health center staff experience in NCQA PCMH-recognized health centers serving low-income, minority groups in New Jersey? 4) What has been the health center staff experience in NCQA PCMH-recognized centers in New Jersey regarding burnout? Fifteen NCQA PCMH-recognized New Jersey FQHCs were included in the sample. Quantitative methods were used to examine 2016-2018 Uniform Data System (UDS) data, including quality of care measures for FQHC patients diagnosed with hypertension, diabetes, and coronary artery disease, as well as prevention screenings for obesity and depression. Qualitative content analysis was used to analyze 990 online Google FQHC patient reviews and 295 online Indeed FQHC employee reviews. A constructed hybrid framework guided the analysis.
Study findings suggest the need to design a health care delivery model that reduces health disparities. Future research should examine other health care delivery models for their ability to reduce health disparities and explore the impact of public policies designed to address inequities. Targeted investment in FQHCs may yet yield an equitable and scalable health system that reduces health disparities and works for all regardless of racial, ethnic or socioeconomic status.
NotePh.D.
NoteIncludes bibliographical references
Genretheses, ETD doctoral
LanguageEnglish
CollectionGraduate School - Newark Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.