The Patient-Centered Medical Home and Patient Experience

Department of Health Policy and Administration, Pennsylvania State University, 610 N Euclid Ave, Pittsburgh, PA, 15206.
Health Services Research (Impact Factor: 2.49). 06/2012; 47(6). DOI: 10.1111/j.1475-6773.2012.01429.x
Source: PubMed

ABSTRACT OBJECTIVE: To examine the relationship between practices' reported use of patient-centered medical home (PCMH) processes and patients' perceptions of their care experience. DATA SOURCE: Primary survey data from 393 physician practices and 1,304 patients receiving care in those practices. STUDY DESIGN: This is an observational, cross-sectional study. Using standard ordinary least-squares and a sample selection model, we estimated the association between patients' care experience and the use of PCMH processes in the practices where they receive care. DATA COLLECTION: We linked data from a nationally representative survey of individuals with chronic disease and two nationally representative surveys of physician practices. PRINCIPAL FINDINGS: We found that practices' use of PCMH processes was not associated with patient experience after controlling for sample selection as well as practice and patient characteristics. CONCLUSIONS: In our study, which was large, but somewhat limited in its measures of the PCMH and of patient experience, we found no association between PCMH processes and patient experience. The continued accumulation of evidence related to the possibilities of the PCMH, how PCMH is measured, and how the impact of PCMH is gauged provides important information for health care decision makers.


Available from: Dennis Scanlon, May 07, 2015
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    ABSTRACT: Objectives To examine which components of medical homes affect time families spend arranging/coordinating health care for their children with special health care needs (CSHCNs) and providing health care at home.Data Sources2009–2010 National Survey of Children with Special Health Care Needs (NS-CSHCN), a population-based survey of 40,242 CSHCNs.Study DesignNS-CSHCN is a cross-sectional, observational study. We used generalized ordered logistic regression, testing for nonproportional odds in the associations between each of five medical home components and time burden, controlling for insurance, child health, and sociodemographics.Data Collection/Extraction Methods Medical home components were collected using Child and Adolescent Health Measurement Initiative definitions.Principal FindingsFamily-centered care, care coordination, and obtaining needed referrals were associated with 15–32 percent lower odds of time burdens arranging/coordinating and 16–19 percent lower odds providing health care. All five components together were associated with lower odds of time burdens, with greater reductions for higher burdens providing care.Conclusions Three of the five medical home components were associated with lower family time burdens arranging/coordinating and providing health care for children with chronic conditions. If the 55 percent of CSHCNs lacking medical homes had one, the share of families with time burdens arranging care could be reduced by 13 percent.
    Health Services Research 08/2014; 50(2). DOI:10.1111/1475-6773.12215 · 2.49 Impact Factor
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    ABSTRACT: Few studies have evaluated whether the patient-centered medical home (PCMH) supports patient activation and none have evaluated whether support for patient activation differs among racial and ethnic groups or by health status. This is critical because activation is lower on average among minority patients and those in poorer health.
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    ABSTRACT: Background The patient-centred medical home (PCMH) is a healthcare delivery model that aims to make health care more effective and affordable and to curb the rise in episodic care resulting from increasing costs and sub-specialisation of health care. Although the PCMH model has been implemented in many different healthcare settings, little is known about the PCMH in rural or underserved settings. Further, less is known about patients' understanding of the PCMH and its effect on their care. Aims The goal of this project was to ascertain the patient perspective of the PCMH and develop meaningful language around the PCMH to help inform and promote patients' participation with the PCMH. Method The High Plains Research Network Community Advisory Council (CAC) is comprised of a diverse group of individuals from rural eastern Colorado. The CAC and its academic partners started this project by receiving a comprehensive education on the PCMH. Using a community-based participatory research approach, the CAC translated technical medical jargon on the PCMH into a core message that the 'Medical Home is Relationship'. Results The PCMH should focus on the relationship of the patient with their personal physician. Medical home activities should be used to support and strengthen this relationship. Conclusion The findings serve as a reminder of the crucial elements of the PCMH that make it truly patient centred and the importance of engaging local patients in developing and implementing the medical home.
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