Estimating the Cost of a Medical Home Transformation

描述（由申请人提供）：最近发表的一份关于患者和工作人员经验、护理过程、临床和经济结果的证据的系统综述得出结论：“虽然PCMH有望改善患者和工作人员的体验，并有可能改善护理过程……目前的证据不足以确定对临床和大多数经济结果的影响。”我们建议进行研究，以帮助解决与医疗家庭原则相一致的医疗保健系统转型成本的不完整证据，以及归因于这种转型的医疗服务成本变化。这项研究将在团体保健合作社内进行，这是一个综合保健系统，通过在华盛顿州经营诊所的综合团体实践，为大约45万人提供全面的保健和预防服务。在集团健康内部进行这项研究的优势在于，它是一个单一的组织，既通过一个健康计划为其所有成员的健康服务提供资金，又通过拥有和经营的初级保健诊所和专业中心直接提供医疗保健。因此，我们可以衡量每个诊所转变为医疗之家的健康计划所产生的成本，以及这种转变所带来的成本变化。

DESCRIPTION (provided by applicant): A recently published systematic review of evidence on patient and staff experiences, process of care, and clinical and economic outcomes attributable to the Patient-Centered Medical Home (PCMH) concluded that "while the PCMH holds promise for improving the experiences of patients and staff and potentially for improving care processes... current evidence is insufficient to determine effects on clinical and most economic outcomes." We propose research to help address the incomplete evidence about the cost of transforming a health care system aligned with medical home principles as well as the change in heath service cost attributable to this transformation. This research will be conducted within Group Health Cooperative, an integrated health care system that provides comprehensive health and preventive services to approximately 450,000 people in an integrated group practice that operates clinics throughout Washington State. The advantage of conducting this research within Group Health is that it is a single organization that both finances health car through a health plan that insures all of its members' health services and directly provides health care through owned and operated primary care clinics and specialty centers. Therefore, we can measure the costs incurred by the health plan of transformation each of its clinics into medical homes as well as the change in costs brought about by this transformation.