A Research Agenda for the Patient Centered Medical Home

描述（由申请人提供）：许多政策制定者认识到初级保健迫在眉睫的危机。对初级保健医生不断增加的需求和低报销的结合，使这一职业在医疗行业中相对没有吸引力。然而，研究表明，建立在初级保健基础上的保健系统具有更高的质量和更低的成本。以患者为中心的医疗之家（PCMH）的概念正在作为一种新的初级保健模式出现，它可以缓解这些问题，同时促进以人口为基础、以患者和家庭为中心的医疗服务模式，并超越当前基于就诊的报销系统的限制。PCMH的联合原则得到了许多专业医疗组织的支持，包括普通内科医学会（SGIM）、家庭医学教师协会（STFM）和学术儿科协会（APA）。为了广泛实施这种护理模式，决策者需要证据证明，通过护理协调提高质量和节省成本、增加获得预防性保健的机会以及改善慢性病管理将抵消这种新模式所需的任何增加的支出

DESCRIPTION (PROVIDED BY APPLICANT): Many policy makers recognize an impending crisis in primary care. The combination of ever increasing demands on primary care physicians and low reimbursement have rendered this a relatively unattractive career within the medical profession. Yet, research suggests that systems of care built upon a foundation of primary care have both higher quality and lower costs. The concept of the patient-centered medical home (PCMH) is emerging as a new model of primary care that could alleviate these problems while promoting a model of care delivery that is population based and patient and family-centered, and that moves beyond the constraints of the current visit-based reimbursement system. The Joint Principles of PCMH have gained support from numerous professional medical organizations including the Society of General Internal Medicine (SGIM), Society of Teachers of Family Medicine (STFM) and Academic Pediatrics Association (APA). In order to broadly implement this model of care, policy makers need evidence that the improved quality and cost savings from care coordination, enhanced access to preventive health care, and improved management of chronic disease will offset any increased expenditures required by this new model of care. This creates a need for a health services research agenda that will help move the PCMH from a demonstration model to an evidenced-based standard of care. We therefore propose to organize an invitational conference to develop a policy-relevant research agenda around the PCMH to take place in 2009. The conference will convene national researchers, major primary care professional organizations, health care purchasers, payers, patient advocates, and policy makers. We seek funding to accomplish the following conference objectives: 1. To Inform and advance the state of the art and science and real world experience about the PCMH; 2. To develop partnerships and build capacity to implement a practical evaluation model that can be used by health plans, government payers, and policy makers to assess components of the PCMH and alternative models; 3. To develop and recommend a research agenda to inform the development and broad implementation of the PCMH model; and 4. To disseminate the synthesis of the conference via the peer-reviewed literature, the web, and presentations at relevant national health policy and professional association meetings.