Needs Assessment for a Patient Centered Medical Home Model of Care at the Providence Alaska Cancer Center

Abstract

In order to better understand the needs of cancer patients and allocate resources, the Providence Alaska Cancer Center requested a needs assessment for an oncology focused patient centered medical home (PCMH). A PCMH allows for coordinated and comprehensive care through the use of a teamwork model that centers on the primary care physician. The Providence Alaska Cancer Center staff randomly selected the records of 200 cancer patients between 2010 and 2011, using the cancer tumor registry. Data were analyzed to answer four specific questions that addressed the 1) presence of a Primary Care Physician (PCP), 2) number and type of comorbidities, 3) cancer diagnosis and 4) insurance status impacted emergency room utilization. Individuals tended to utilize the emergency room more if they 1) had a PCP, 2a) had three or more comorbidities, 2b) were diagnosed with hyperlipidemia, chronic obstructive pulmonary disease (COPD) or hypertension, 3) were diagnosed with an “other” cancer as opposed to breast, lung or gynecological cancers or 4) had federal insurance. These data in particular show expected trends such as patients who have more medical complications have higher emergency room utilization rates than patients with less complicated medical history and that certain comorbidities (hyperlipidemia, hypertension and chronic obstructive pulmonary disease) may be predictors of emergency room utilization. These trends may allow providers to create more specialized treatment and care plans for patients at greater risk of emergency room utilization.