Managing drug-related morbidity and mortality in the patient-centered medical home.

Abstract:

BACKGROUND:The appropriate use of medications can influence quality performance measures and costs. Drug-related morbidity and mortality represents a public health challenge due to the ineffective and unsafe consequences of medication use. This article addresses the impact of team-based care that incorporates comprehensive medication therapy management on per capita expenditures, quality performance measures, and resolution of drug therapy problems. METHODS:A team-based medication therapy management system developed over 13 years in an integrated health system in 4 Minnesota innovation clinic sites was assessed in terms of: (1) differences in total median health expenditures compared with noninnovation clinics, (2) improvements on 5 performance benchmarks for patients with diabetes in comparison with statewide results, and (3) resolution of drug therapy problems. RESULTS:Spending growth was 11% less in innovation clinics than that in 38 noninnovation clinics. Median per member per month health care costs measured at 5 intervals over a 15-month period were significantly lower in innovation than in noninnovation sites (P=0.05). Forty percent of patients with diabetes in the innovation clinics achieved all 5 performance benchmark treatment goals in 2009, with a range from 34% to 45%, compared with the statewide result of 17.5% of patients achieving all 5 benchmarks. In addition, over 4000 drug therapy problems were reported to be resolved. CONCLUSIONS:Team-based care helped to achieve quality performance and control spending growth through medication therapy management in a patient-centered medical home innovation.

journal_name

Med Care

journal_title

Medical care

authors

Isetts BJ,Brummel AR,de Oliveira DR,Moen DW

doi

10.1097/MLR.0b013e31826ecf9a

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

997-1001

issue

11

eissn

0025-7079

issn

1537-1948

pii

00005650-201211000-00014

journal_volume

50

pub_type

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