Elements of the Patient-Centered Medical Home in Family Practices in Virginia
Elements of the Patient-Centered Medical Home in Family Practices in Virginia
复制标题
DOI：
10.1370/afm.1021
复制
发表时间：
2009-07-01
影响因子：
4.4
通讯作者：
Kuzel, Anton J.
中科院分区：
文献类型：
--
作者：
Goldberg, Debora Goetz;Kuzel, Anton J.
目的 以患者为中心的医疗之家 (PCMH) 是一种被广泛接受的实践模型理论，旨在提高护理质量、患者满意度和获得初级护理服务的机会。本研究探讨了弗吉尼亚州 PCMH 的现有要素和家庭实践的特征。方法我们制定并实施了一份调查问卷，以获取有关实践特征和 PCMH 要素的信息。我们从弗吉尼亚州医学委员会执业者信息数据库的实践人群中随机抽取了弗吉尼亚州的 700 个家庭医学办公室。我们采用了混合模式调查，允许样本中的诊所通过邮件、互联网或在地区家庭医学会议上做出回应。结果 调查的回应率为 56%，有 342 个办公地点参与了这项研究。大多数实践报告了连续性护理流程（87%）和临床指南（77%）。使用患者调查（48%）、用于内部协调的电子病历（38%）、用于护理的社区联系（31%）和临床表现测量（28%）的报告较少。少数报告了多种疾病的患者登记情况（19%）。很少有实践能够展现 PCMH 模型中概述的所有要素 (1%)。诊所规模（医生数量）与 PCMH 模型一致性显着相关。 结论 弗吉尼亚州的大多数家庭诊所都表现出 PCMH 模型的一些要素。 PCMH模型的全面实施率较低。在指导工作、评估进展和制定护理模式改革政策时，应考虑有关诊所特征、PCMH 流行率和小型诊所挑战的基线信息。
PURPOSE The patient-centered medical home (PCMH) is a widely accepted theory of a practice model to improve quality of care, patient satisfaction, and access to primary care services. This study explores existing elements of the PCMH and characteristics of family practices in Virginia.METHOD We developed and administered a survey questionnaire to capture information on practice characteristics and PCMH elements. We randomly sampled 700 family medicine offices in Virginia from a population of practices derived from the Virginia Board of Medicine Practitioner information Database. We used a mixed-mode survey, allowing practices in the sample to respond by mail or Internet or at a regional family medicine conference.RESULTS The survey resulted in a response rate of 56%, with 342 office locations participating in the study. Most practices reported Continuity-of-care processes (87%) and clinical guidelines (77%). Fewer reported use of patient surveys (48%), electronic medical record for internal coordination (38%), community linkages for care (31%), and clinical performance measurement (28%). A small number reported patient registries for multiple diseases (19%). Very few practices exhibited all elements outlined in the PCMH model (1%). Practice size (number of physicians) is significantly related to PCMH model alignment.CONCLUSIONS Most family practices in Virginia exhibit some elements of the PCMH model. Full implementation of the PCMH model is low. Baseline information on practice characteristics, prevalence of PCMH, and challenges of small practices should be considered in guiding efforts, evaluating progress, and developing policies for care model reform.