Review

Patient Opinion Regarding Patient-Centered Medical Home Fundamentals

Authors: Randell K. Wexler, MD, MPH, Dana E. King, MD, MS, Mark Andrews, MD

Abstract

Objectives: Although conceptually there is agreement on how the Patient-Centered Medical Home (PCMH) should be organized, there is little information regarding which PCMH components are the most important to patients.


Methods: An anonymous, voluntary survey was administered to patients at three US academic medical centers. Questions sought opinions regarding the National Committee for Quality Assurance’s key components and essential elements of the PCMH. Analysis of the survey responses was conducted using SAS version 9.1.


Results: A total of 780 surveys were returned. Patients expressed believing strongly that the ability to coordinate care, help patients to manage their own disease, and track laboratory results were the most important aspects of a PCMH office. There were no differences in response to the survey according to age, sex, race, or site. Patients listed care coordination, patient self-management, and improved access to care as the top priority attributes of a PCMH.


Conclusions: Patients were consistent in their opinions that care coordination, access, and patient self-management were the most important elements of a PCMH.

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References

1. Sia C, Tonniges TF, Osterhus E, et al. History of the medical home concept. Pediatrics 2004; 113: 1473–1478.
 
2. American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Osteopathic Association. Joint principles of the Patient-Centered Medical Home. http://www.medicalhomeinfo.org/joint%20Statement.pdf. Accessed August 30, 2010.
 
3. Beal AC, Doty MM, Hernandez SE, et al. Closing the divide: how medical homes promote equity in health care: results from the Commonwealth Fund 2006 Health Care Quality Survey. http://www.commonwealthfund.org/Publications/Fund-Reports/2007/Jun/Closing-the-Divide–How-Medical-Homes-Promote-Equity-in-Health-Care–Results-From-The-Commonwealth-F.aspx. Published June 2007. Accessed February 7, 2012.
 
4. Bodenhemier T. Coordinating care: a perilous journey through the health system. N Engl J Med 2008; 358: 1064–1072.
 
5. Adams J, Grundy P, Kohn MS, et al. Patient-centered medical home: what, why, and how. http://www-935.ibm.com/services/us/gbs/bus/html/gbs-medical-home.html. Accessed February 7, 2012.
 
6. Reid RJ, Fishman PA, Onchee Y, et al. Patient-Centered Medical Home demonstration: a prospective, quasi-experimental, before and after evaluation. Am J Manag Care 2009; 15: e71–e87.
 
7. Grumbach K, Bodenheimer T, Grundy P. Outcomes of implementing patient-centered medical home interventions: a review of the evidence from prospective evaluation studies in the United States. http://www.pcpcc.net/content/pcmh-outcome-evidence-quality. Accessed November 1, 2010.
 
8. National Committee for Quality Assurance. Physician Practice Connections-Patient-Centered Medical Home. http://www.ncqa.org/tabid/631/default.aspx. Accessed March 2, 2010.
 
9. Hudon C, Fortin M, Haggerty JL. Measuring a patient’s perspective on patient-centered care: a systematic review of tools for family medicine. Ann Fam Med 2011; 9: 155–164.
 
10. Berenson RA, Hammons T, Gans DN, et al. A house is not a home: keeping patients at the center of practice redesign. Health Aff 2008; 27: 1219–1230.
 
11. Friedberg MW, Lai DJ, Hyssey PS, et al. A guide to the medical home as a practice-level intervention. Am J Manag Care 2009; 15: S291–S299.
 
12. Jaen CR, Ferrer RL, Miller WT, et al. Patient outcomes at 26 months in the patient-centered medical home national demonstration project. Ann Fam Med 2010; 8: s57–s67.
 
13. Reid RJ, Coleman K, Johnson AJ, et al. The group health medical home at year two: cost savings, higher patient satisfaction, and less burnout for providers. Health Aff (Millwood) 2010; 29: 835–843.
 
14. Kripalani S, LeFevre F, Phillips C, et al. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA 2007; 297: 831–841.
 
15. Hanasagi H, Olsson M, Hussain A, et al. Is information sharing between the emergency department and primary care useful to the care of frequent emergency department users? Eur J Emerg Med 2008; 15: 34–39.
 
16. Afilal M, Lang E, Leger R. Impact of a standardized communication system on continuity of care between family physicians and the emergency department. Can J Emerg Med 2007; 9: 79–86.
 
17. WHO Collaborating Centre for Patient Safety Solutions. Communication during patient hand-overs. Patient safety solutions, vol 1, solution 3. www.ccforpatientsafety.org/common/pdfs/fpdf/presskit/PS-Solution3.pdf. Published May 2007. Accessed February 7, 2012.
 
18. Johnson JK, Arora VM. Improving clinical handovers: creating local solutions for a global problem. Qual Saf Health Care 2009; 18: 244–245.
 
19. Steinbauer JR, Korell K, Erdin J, et al. Implementing open-access scheduling in an academic practice. Fam Pract Manag 2006; 13: 59–64.
 
20. Mehrotra A, Keehl-Markowitz L, Ayanian JZ. Implementing open-access scheduling of visits in primary care practices: a cautionary tale. Ann Intern Med 2008; 148: 915–922.
 
21. Murray M, Berwick DM. Advanced access: reducing waiting and delays in primary care. JAMA 2003; 289: 1035–1040.
 
22. Murray M, Tantau C. Same-day appointments: exploding the access paradigm. Fam Pract Manag 2000; 7: 45–50.
 
23. Christakis DA, Mell L, Koepsell TD, et al. Association of lower continuity of care with greater risk of emergency department use and hospitalization in children. Pediatrics 2001; 107: 524–529.
 
24. Cunningham PJ, May JH. Insured Americans drive surge in emergency department visits. http://hschange.org/CONTENT/613. Published October 2003. Accessed February 7, 2012.
 
25. Keeping chronically ill patients out of the ED. Hosp Case Manag 2008; 16: 68–70.
 
26. Machlin SR. Expenses for a hospital emergency room visit, 2003. Medical Expenditure Panel Survey Statistical Brief 111. http://meps.ahrq.gov/mepsweb. Published January 2006. Accessed February 7, 2012.
 
27. Schall M, Sevin C, Wasson JH. Making high-quality, patient-centered care a reality. J Ambul Care Manag 2009; 32: 3–7.