%0 Journal Article
%T A Bayesian Difference-in-Difference Framework for the Impact of Primary Care Redesign on Diabetes Outcomes
%A Bradley Carlin
%A Caroline Carlin
%A Eric Lock
%A James Normington
%A Kevin Peterson
%J Statistics and Public Policy
%D 2019
%R https://doi.org/10.1080/2330443X.2019.1626310
%X Abstract Although national measures of the quality of diabetes care delivery demonstrate improvement, progress has been slow. In 2008, the Minnesota legislature endorsed the patient-centered medical home (PCMH) as the preferred model for primary care redesign. In this work, we investigate the effect of PCMH-related clinic redesign and resources on diabetes outcomes from 2008 to 2012 among Minnesota clinics certified as PCMHs by 2011 by using a Bayesian framework for a continuous difference-in-differences model. Data from the Physician Practice Connections-Research Survey were used to assess a clinic¡¯s maturity in primary care transformation, and diabetes outcomes were obtained from the MN Community Measurement program. These data have several characteristics that must be carefully considered from a modeling perspective, including the inability to match patients over time, the potential for dynamic confounding, and the hierarchical structure of clinics. An ad-hoc analysis suggests a significant correlation between PCMH-related clinic redesign and resources on diabetes outcomes; however, this effect is not detected after properly accounting for different sources of variability and confounding. Supplementary materials for this article are available online
%U https://www.tandfonline.com/doi/full/10.1080/2330443X.2019.1626310