Article

Measuring The Medical Home Infrastructure In Large Medical Groups

Family and Community Medicine, University of California (UC), San Francisco, USA.
Health Affairs (Impact Factor: 4.64). 09/2008; 27(5):1246-58. DOI: 10.1377/hlthaff.27.5.1246
Source: PubMed

ABSTRACT The patient-centered medical home is taking center stage in discussions of primary care innovation as a new delivery model that provides comprehensive, coordinated care across the lifespan. Although the medical home is widely discussed by policymakers, payers, and other stakeholders, the extent to which physician practices have the infrastructure in place to function as medical homes is not known. Using data from the 2006-07 National Study of Physician Organizations, we examine the extent of adoption of medical home infrastructure components among large primary care and multispecialty medical groups and their association with medical group size and ownership.

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    • "There has been a sharp increase in hospital-owned medical practices relative to physician-owned ones since 2005 (Harris, 2010). The increase is attributed to the complexity of contracting with payers, developing information systems including electronic health records and a desire for more regular working hours (Pham and Ginsburg, 2008; Rittenhouse, Casalino et al., 2008). This shift has potential to promote better integration of health services. "
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    ABSTRACT: USA with an emphasis on the comparison of business schools and health science settings. It seeks to explain why different organizational cultures exist and how this affects education. Design/methodology/approach – The approach relies on literature review and descriptive analysis using secondary data. Institutional economics helps provide perspective on different academic cultures and orientations. Findings – Healthcare management education originated in the early twentieth century. Business schools at the University of Chicago and Northwestern were early pioneers. By mid-century, schools of public health and medicine entered and came to dominate with strong graduate programs at Berkeley, Michigan and other leading universities. More recently, business schools have differentiated away from the generic MBA and expanded into this market. Advocates of health science settings commonly see healthcare as different from other forms of management. The externally funded model of medical education relying on patient and grant revenues dominates the health sciences. This can lead to preference for faculty who generate funds and a neglect of core academic areas that historically have not relied on grants and contracts. Practical implications – This history of health management education provides insight for students, researchers, educators and administrators. It underscores comparative advantage of different academic settings. Originality/value – This paper serves to fill a gap in the management literature. It provides history and perspective about academic settings not readily available.
    Journal of Management History 10/2012; 18(4):386-401.
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    • "There has been a sharp increase in hospital-owned medical practices relative to physician-owned ones since 2005 (Harris, 2010). The increase is attributed to the complexity of contracting with payers, developing information systems including electronic health records and a desire for more regular working hours (Pham and Ginsburg, 2008; Rittenhouse, Casalino et al., 2008). This shift has potential to promote better integration of health services. "
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    ABSTRACT: Purpose ‐ This paper aims to provide a history of graduate healthcare management education in the USA with an emphasis on the comparison of business schools and health science settings. It seeks to explain why different organizational cultures exist and how this affects education. Design/methodology/approach ‐ The approach relies on literature review and descriptive analysis using secondary data. Institutional economics helps provide perspective on different academic cultures and orientations. Findings ‐ Healthcare management education originated in the early twentieth century. Business schools at the University of Chicago and Northwestern were early pioneers. By mid-century, schools of public health and medicine entered and came to dominate with strong graduate programs at Berkeley, Michigan and other leading universities. More recently, business schools have differentiated away from the generic MBA and expanded into this market. Advocates of health science settings commonly see healthcare as different from other forms of management. The externally funded model of medical education relying on patient and grant revenues dominates the health sciences. This can lead to preference for faculty who generate funds and a neglect of core academic areas that historically have not relied on grants and contracts. Practical implications ‐ This history of health management education provides insight for students, researchers, educators and administrators. It underscores comparative advantage of different academic settings. Originality/value ‐ This paper serves to fill a gap in the management literature. It provides history and perspective about academic settings not readily available.
    09/2012; 18(4). DOI:10.1108/17511341211258738
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    • "ThemainindependentvariableisthePCMHIndex,whichmeasurestheuse ofspecificPCMHprocesses.Thisindexiscomprisedoffoursubindicesthat measure4of7principlesofthePCMHmodel,whichwerecombinedtoform asingleindex.Thesesubindicesarecreatedusingthesameapproachaspreviousstudies(Rittenhouseetal.2008,2011)andincludethefollowing:physi- cian-directedmedicalpractice,coordinationandintegration,qualityand safety,andenhancedaccess.ThespecificcomponentsareoutlinedinAppen- dixS2. "
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    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.
    Health Services Research 06/2012; 47(6). DOI:10.1111/j.1475-6773.2012.01429.x · 2.49 Impact Factor
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