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Social justice in health: the patient-centered medical home and health disparities
Descriptive
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Title
Social justice in health: the patient-centered medical home and health disparities
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Anderson
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Denise
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1978
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Denise Anderson
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author
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Sabrina Marie
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Sabrina Marie Chase
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Advisory Committee
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chair
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Zha
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Peijia
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Peijia Zha
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Advisory Committee
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internal member
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Powell
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Arthur
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Arthur Powell
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Advisory Committee
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internal member
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Shi
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Leiyu
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Leiyu Shi
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Advisory Committee
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outside member
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Rutgers University
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degree grantor
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Graduate School - Newark
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school
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theses
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2021
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2021-01
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English
Abstract
Currently, 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.
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.
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Topic
Patient-centered medical home
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Urban Systems
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Rutgers University Electronic Theses and Dissertations
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ETD_11311
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1 online resource (xii, 212 pages)
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Ph.D.
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Includes bibliographical references
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ETD doctoral
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Graduate School - Newark Electronic Theses and Dissertations
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rucore10002600001
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NjNbRU
Identifier
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doi:10.7282/t3-twb8-mw51
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Rights
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The author owns the copyright to this work.
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Name
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Anderson
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Denise
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Permission or license
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2020-11-21 17:39:46
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Denise Anderson
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Rutgers University. Graduate School - Newark
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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