Small And Medium-Size Physician Practices Use Few Patient-Centered Medical Home Processes
Small And Medium-Size Physician Practices Use Few Patient-Centered Medical Home Processes
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DOI：
10.1377/hlthaff.2010.1210
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发表时间：
2011-08-01
期刊：
影响因子：
9.7
通讯作者：
Drum, Melinda L.
中科院分区：
文献类型：
--
作者：
Rittenhouse, Diane R.;Casalino, Lawrence P.;Drum, Melinda L.
以患者为中心的医疗院已成为改革向患者提供医疗服务的方式的突出模式。该模式提供了一个强大的初级保健系统，结合了实践创新和新的支付方法。但关于典型的美国医生实践在多大程度上实施了这一模式及其护理过程，或者与实施相关的因素，信息很少。在这篇文章中，我们提供了在1344家中小型医生诊所中使用医疗之家流程的第一批国家数据，如慢性病登记处、护士护理经理和纳入患者反馈的系统。我们发现，平均而言，在本研究中测量的以患者为中心的医疗家庭流程中，实践仅使用了五分之一。我们还确定了与更多地使用医疗家庭流程相关的内部能力和外部激励措施。
The patient-centered medical home has become a prominent model for reforming the way health care is delivered to patients. The model offers a robust system of primary care combined with practice innovations and new payment methods. But scant information exists about the extent to which typical US physician practices have implemented this model and its processes of care, or about the factors associated with implementation. In this article we provide the first national data on the use of medical home processes such as chronic disease registries, nurse care managers, and systems to incorporate patient feedback, among 1,344 small and medium-size physician practices. We found that on average, practices used just one-fifth of the patient-centered medical home processes measured as part of this study. We also identify internal capabilities and external incentives associated with the greater use of medical home processes.