Patient-centered medical home: Developing, expanding, and sustaining a role for pharmacists
Patient-centered medical home: Developing, expanding, and sustaining a role for pharmacists
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DOI：
10.2146/ajhp110470
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发表时间：
2012-06-15
影响因子：
2.7
通讯作者：
Standiford, Connie J.
中科院分区：
文献类型：
--
作者：
Choe, Hae Mi;Farris, Karen B.;Standiford, Connie J.
目的。本文介绍了密歇根大学以患者为中心的医疗之家（PCMH）卫生保健模式的发展和药剂师在PCMH中的作用。2009年，密歇根蓝十字蓝盾（BCBSM）为医生团体实施PCMH原则提供财政激励。在密歇根大学卫生系统（UMHS）的药学系、药学院和教师团体实践之间建立了合作伙伴关系，将临床药剂师整合到PCMH模式中，在八个全科医学实践中。其基本原理是PCMH药剂师可以通过替代或增加医生护理来帮助管理慢性病，帮助实现质量指标，并通过为其服务计费来增加收入。在密歇根大学，PCMH药剂师目前在8个普通医疗保健中心为糖尿病、高血压、高脂血症和多种药物患者提供直接的患者护理服务，这些服务使用T码计费，大多数BCBSM计划向UMHS支付。在第一年，每个保健中心的药剂师半天诊所的数量从1个到6个不等，每个半天诊所的平均病人人数从2.2个到6个不等。4家PCMHs的药剂师每次就诊的药物变更次数多于其他4家，尤其是糖尿病患者。在密歇根大学，PCMH药剂师目前在8个普通医学健康中心为糖尿病、高血压、高脂血症和多种药物患者提供直接的患者护理服务。[J]卫生系统医药。2012；69:1063 - 71
Purpose. The development of a patient-centered medical home (PCMH) health care model and the role of pharmacists in PCMHs at the University of Michigan are described.Summary. In 2009, Blue Cross Blue Shield of Michigan (BCBSM) provided financial incentives to physician groups to implement PCMH principles. A partnership was formed among the department of pharmacy, college of pharmacy, and faculty group practice at the University of Michigan Health System (UMHS) to integrate clinical pharmacists into the PCMH model at eight general medicine practices. The rationale was that PCMH pharmacists could assist in managing chronic conditions by substituting or augmenting physician care, help achieve quality indicators, and increase revenue by billing for their services. At the University of Michigan, PCMH pharmacists currently provide direct patient care services at eight general medicine health centers for patients with diabetes, hypertension, hyperlipidemia, and polypharmacy, which are billable using T codes, which are payable to UMHS by most BCBSM plans. In the first year, the number of PCMH pharmacist half-day clinics varied from one to six per health center, and the mean number of patients per half-day clinic ranged from 2.2 to 6. Pharmacists in four PCMHs made more medication changes per visit than the other four, particularly for patients with diabetes.Conclusion. At the University of Michigan, PCMH pharmacists currently provide direct patient care services at eight general medicine health centers for patients with diabetes, hypertension, hyperlipidemia, and polypharmacy via referral from physicians. Am J Health-Syst Pharm. 2012; 69:1063-71