{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:15:19Z","timestamp":1789517719934,"version":"build-2803163510"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"funder":[{"name":"Local Health Authority of Parma, Italy"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"published-print":{"date-parts":[[2022,5]]},"DOI":"10.1007\/s11606-021-07040-9","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T15:03:24Z","timestamp":1628262204000},"page":"1380-1387","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Medical Home Initiative in Italy: an Analysis of Changes in Healthcare Utilization"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9428-1151","authenticated-orcid":false,"given":"Scott W.","family":"Keith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dexter","family":"Waters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5604-721X","authenticated-orcid":false,"given":"Matthew","family":"Alcusky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hegarty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niusha","family":"Jafari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Lombardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Pini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9971-6989","authenticated-orcid":false,"given":"Vittorio","family":"Maio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"issue":"1","key":"7040_CR1","first-page":"21","volume":"80","author":"American Academy of Family P","year":"2008","unstructured":"American Academy of Family P. Joint principles of the patient-centered medical home. Del Med J. 2008;80(1):21-22.","journal-title":"Del Med J."},{"key":"7040_CR2","volume-title":"Integrated Primary and Behavioral Care","author":"C Lionis","year":"2015","unstructured":"Lionis C, Petelos E. The patient-centered medical home model within an integrated primary care system: towards a European model? In: O\u2019donohue W. MA, ed. Integrated Primary and Behavioral Care. Springer; 2015."},{"issue":"4","key":"7040_CR3","first-page":"1","volume":"16","author":"F Ferre","year":"2014","unstructured":"Ferre F, de Belvis AG, Valerio L, et al. Italy: health system review. Health Syst Transit. 2014;16(4):1-168.","journal-title":"Health Syst Transit"},{"key":"7040_CR4","unstructured":"Donatini A. The Italian Health Care System. The Commonwealth Fund. https:\/\/international.commonwealthfund.org\/countries\/italy\/. Published 2016. Accessed May 14, 2020."},{"key":"7040_CR5","unstructured":"Italy Ministry of Health. Ministerial Decree 10 July 2007. Projects implementing the National Health Plan - Guidelines for access to co-financing to the regions and autonomous provinces of Trento and Bolzano. http:\/\/www.salute.gov.it\/imgs\/C_17_normativa_1471_allegato.pdf. Published 2007. Accessed February 17, 2020."},{"key":"7040_CR6","unstructured":"Regione Emilia-Romagna. Case della Salute. http:\/\/salute.regione.emilia-romagna.it\/cure-primarie\/case-della-salute. Accessed April 10, 2020."},{"key":"7040_CR7","unstructured":"Regione Emilia-Romagna. Dettaglio Atto Amministrativo. http:\/\/servizissiir.regione.emilia-romagna.it\/deliberegiunta\/servlet\/AdapterHTTP?action_name=ACTIONRICERCADELIBERE&operation=leggi&cod_protocollo=GPG\/2016\/2253&ENTE=1. Accessed April 10, 2020."},{"issue":"6","key":"7040_CR8","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1177\/1062860615597744","volume":"31","author":"M Alcusky","year":"2016","unstructured":"Alcusky M, Ferrari L, Rossi G, Liu M, Hojat M, Maio V. Attitudes toward collaboration among practitioners in newly established medical homes: a survey of nurses, general practitioners, and specialists. Am J Med Qual. 2016;31(6):526-535.","journal-title":"Am J Med Qual."},{"issue":"3","key":"7040_CR9","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1177\/1062860619860590","volume":"35","author":"M Alcusky","year":"2020","unstructured":"Alcusky M, Singer D, Keith SW, et al. Evaluation of care processes and health care utilization in newly implemented medical homes in Italy: a population-based cross-sectional study. Am J Med Qual. 2020;35(3):265-273.","journal-title":"Am J Med Qual."},{"key":"7040_CR10","unstructured":"Azienda Unit\u00e0 Sanitaria Locale di Parma. Bilancio di Missione 2011. https:\/\/salute.regione.emilia-romagna.it\/normativa-edocumentazione\/rapporti\/archivio\/bilanci-di-missione-delle-aziende-sanitarie\/ausl_pr_bm2011.pdf. Accessed July 22, 2021."},{"key":"7040_CR11","unstructured":"Jabbarpour Y, DeMarchis E, Bazemore A, Grundy P. The impact of primary care practice transformation on cost, quality, and utilization \u2013 a systematic review of research published in 2016. Patient-Centered Primary Care Collaborative. 2017."},{"issue":"3","key":"7040_CR12","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1377\/hlthaff.2016.1235","volume":"36","author":"AD Sinaiko","year":"2017","unstructured":"Sinaiko AD, Landrum MB, Meyers DJ, et al. Synthesis of research on patient-centered medical homes brings systematic differences into relief. Health Aff (Millwood). 2017;36(3):500-508.","journal-title":"Health Aff (Millwood)."},{"issue":"1","key":"7040_CR13","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1111\/1475-6773.12319","volume":"51","author":"JM Bronstein","year":"2016","unstructured":"Bronstein JM, Morrisey MA, Sen B, Engler S, Smith WK. Initial impacts of the patient care networks of Alabama initiative. Health Serv Res. 2016;51(1):146-166.","journal-title":"Health Serv Res."},{"issue":"11","key":"7040_CR14","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1007\/s11606-016-3814-z","volume":"31","author":"A Cuellar","year":"2016","unstructured":"Cuellar A, Helmchen LA, Gimm G, et al. The CareFirst patient-centered medical home program: cost and utilization effects in its first three years. J Gen Intern Med. 2016;31(11):1382-1388.","journal-title":"J Gen Intern Med."},{"issue":"4","key":"7040_CR15","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1377\/hlthaff.2014.0855","volume":"34","author":"DD Maeng","year":"2015","unstructured":"Maeng DD, Khan N, Tomcavage J, Graf TR, Davis DE, Steele GD. Reduced acute inpatient care was largest savings component of Geisinger Health System\u2019s patient-centered medical home. Health Aff (Millwood). 2015;34(4):636-644.","journal-title":"Health Aff (Millwood)."},{"key":"7040_CR16","unstructured":"Peikes D, Anglin G, Taylor E, et al. Evaluation of the comprehensive primary care initiative: third annual report. Math Policy Res. 2016. https:\/\/innovation.cms.gov\/files\/reports\/cpci-evalrpt3.pdf. Accessed July 22, 2021."},{"issue":"8","key":"7040_CR17","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1097\/MLR.0000000000000555","volume":"54","author":"DM Shane","year":"2016","unstructured":"Shane DM, Nguyen-Hoang P, Bentler SE, Damiano PC, Momany ET. Medicaid health home reducing costs and reliance on emergency department: evidence from Iowa. Med Care. 2016;54(8):752-757.","journal-title":"Med Care."},{"issue":"5","key":"7040_CR18","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1097\/MLR.0000000000000347","volume":"53","author":"C Moureaux","year":"2015","unstructured":"Moureaux C, Perelman J, Mendes da Costa E, et al. Impact of the medical home model on the quality of primary care: the Belgian experience. Med Care. 2015;53(5):396-400.","journal-title":"Med Care."},{"issue":"7","key":"7040_CR19","first-page":"e265","volume":"20","author":"S Alidina","year":"2014","unstructured":"Alidina S, Schneider EC, Singer SJ, Rosenthal MB. Structural capabilities in small and medium-sized patient-centered medical homes. Am J Manag Care. 2014;20(7):e265-277.","journal-title":"Am J Manag Care."},{"issue":"3","key":"7040_CR20","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1097\/JAC.0000000000000162","volume":"40","author":"SP Flieger","year":"2017","unstructured":"Flieger SP. Impact of a patient-centered medical home pilot on utilization, quality, and costs and variation in medical homeness. J Ambul Care Manage. 2017;40(3):228-237.","journal-title":"J Ambul Care Manage."},{"key":"7040_CR21","first-page":"46958019900753","volume":"57","author":"JM Hinde","year":"2020","unstructured":"Hinde JM, West N, Arbes SJ, 3rd, Kluckman M, West SL. Did Arkansas\u2019 Medicaid patient-centered medical home program have spillover effects on commercially insured enrollees? Inquiry. 2020;57:46958019900753.","journal-title":"Inquiry."},{"issue":"9","key":"7040_CR22","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1007\/s11606-017-4078-y","volume":"32","author":"JW Timbie","year":"2017","unstructured":"Timbie JW, Hussey PS, Setodji CM, et al. Association between patient-centered medical home capabilities and outcomes for Medicare beneficiaries seeking care from federally qualified health centers. J Gen Intern Med. 2017;32(9):997-1004.","journal-title":"J Gen Intern Med."},{"key":"7040_CR23","unstructured":"Doescher SM, Skillman MA, Rosenblatt RA. Policy brief: the crisis in rural primary care. Seattle, WA: WWAMI Rural Health Research Center, University of Washington, Apr 2009. https:\/\/depts.washington.edu\/uwrhrc\/uploads\/Rural_Primary_Care_PB_2009.pdf. Accessed July 22, 2021."},{"issue":"11","key":"7040_CR24","first-page":"e382","volume":"22","author":"AW Baughman","year":"2016","unstructured":"Baughman AW, Brawarsky P, Onega T, et al. Medical home transformation and breast cancer screening. Am J Manag Care. 2016;22(11):e382-e388.","journal-title":"Am J Manag Care."},{"issue":"22","key":"7040_CR25","doi-asserted-by":"publisher","first-page":"3975","DOI":"10.1002\/cncr.29596","volume":"121","author":"RE Kohler","year":"2015","unstructured":"Kohler RE, Goyal RK, Lich KH, Domino ME, Wheeler SB. Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program. Cancer. 2015;121(22):3975-3981.","journal-title":"Cancer."}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-021-07040-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11606-021-07040-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-021-07040-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,6]],"date-time":"2022-08-06T00:05:42Z","timestamp":1659744342000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11606-021-07040-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,6]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["7040"],"URL":"https:\/\/doi.org\/10.1007\/s11606-021-07040-9","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,6]]},"assertion":[{"value":"25 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted under the auspices of regulation of privacy of the Emilia-Romagna Region N.3 of 24 April 2006 (title: Processing of sensitive data) of act N.1 of 30 May 2014 still in force. This study has been reviewed by the Thomas Jefferson University Institutional Review Board and determined not to constitute human subjects research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"Drs. Keith and Maio affirm that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as originally planned have been explained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Transparency Statement"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}