Defense Date


Document Type


Degree Name

Doctor of Philosophy


Health Administration

First Advisor

Robert Hurley


This study explored how being enrolled in a program that both coordinates patient care and provides a medical home changes health care utilization for uninsured patients, more specifically those persons with chronic conditions, through the use of the Chronic Care Model and Andersen and Aday’s Behavioral Model for Access to Health Care. Uninsured patients typically seek out care in a fragmented manner, which may lead to ineffective and inefficient care, especially for conditions that may require ongoing treatment and monitoring such as chronic conditions. The methodology used to examine the relationship between the interaction of enrollment and chronic condition status and health care utilization was multivariate linear regression. The results of this study show that enrollment in a coordinated care program does have an impact on health care utilization, and that the impact differs for patients with no chronic conditions, a single chronic condition, and multiple chronic conditions. These results point to the effectiveness of implementing the Chronic Care Model to improve access to health care for patients with chronic conditions.


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Date of Submission