Defining and Building a Patient-Centered Medical Home

描述（由申请人提供）：2007年3月，代表初级保健学科的专业协会通过了“以患者为中心的医疗之家（PCMH）的联合原则”。因此，国家质量保证委员会开发了一种工具，将实践认定为pcmhhs。该工具强调实践结构，强调信息技术。目前尚不清楚这些实践结构是否与实际提供的初级保健特征、PCMH的理论基础或患者结果有关。目的：本职业发展建议将1)检验PCMH识别工具与测量初级保健循证特征的工具之间的相关性，2)确定每种工具的潜在因素，以及3)评估PCMH识别工具与测量初级保健循证特征与临床结果的工具之间的相关性。该项目将导致R01申请，以开发一种改进的PCMH识别工具，结合与初级保健和改善临床结果相关的原始工具的元素。候选人：该候选人是密歇根州立大学人类医学院家庭医学系和儿科与人类发展学系联合任命的研究职位的助理教授。培训目标：培训的目标是：1)获得卫生服务系统理论和实践方面的教学培训；2)将理论应用于卫生服务研究，以确定当前PCMH识别工具与初级保健循证特征和改善临床结果相关的特征。研究方法：研究方法包括NCQA PPC-PCMH和PCAT工具的总分和域的相关性分析，每种工具的因素分析，以及每种工具与实践水平临床结果的相关性。结果：结果包括更深入地了解PCMH识别工具与初级保健属性的相关性，以及两者与改善临床结果的关系。益处：结果将用于制定政策，以适当地将实践分类为PCMHs，并根据患者的结果为PCMHs的报销策略提供信息。本研究的成果将有助于理解当前用于识别以患者为中心的医疗之家（PCMHs）临床实践的工具与以证据为基础的初级保健特征和患者结果之间的相关性。研究结果将告知政策制定者当前PCMH识别工具在适当地将实践分类为PCMH方面的效用，并告知支付者当前工具在识别具有更好患者结果的实践方面的效用

DESCRIPTION (provided by the applicant): In March 2007, professional societies representing primary care disciplines endorsed the "Joint Principles of the Patient-Centered Medical Home (PCMH)". Consequently, the National Committee for Quality Assurance developed a tool to recognize practices as PCMHs. The tool emphasizes practice structures with a strong emphasis on information technology. It is unclear that these practice structures are associated with the actual provision of primary care characteristics, the theoretical foundation of a PCMH, or patient outcomes. PURPOSE: This career development proposal will 1) examine the correlation between the PCMH recognition tool and a tool measuring the evidence-based features of primary care, and 2) identify the factors underlying each of the tools, and 3) assess the correlation between the PCMH recognition tool and a tool measuring the evidence-based features of primary care with clinical outcomes. This project will lead to an R01 application to develop an improved tool for PCMH recognition, incorporating elements of the original tool correlated with primary care and with improved clinical outcomes. CANDIDATE: The candidate is an assistant professor in a research position jointly appointed in the Department of Family Medicine and the Department of Pediatrics and Human Development at the Michigan State University College of Human Medicine. TRAINING GOALS: The goals of the training are to 1) gain didactic training in health services systems theories and practice and 2) apply the theories to applications of health services research to identify features of the current PCMH recognition tool correlated with evidence-based features of primary care and improved clinical outcomes. RESEARCH METHODS: The research methods include a correlation analysis of total scores of and domains in the NCQA PPC-PCMH and the PCAT tools, a factor analysis of each tool, and correlation of each tool with clinical outcomes at the practice level. OUTCOMES: The outcomes include a greater understanding of the correlation of PCMH recognition tool with primary care attributes and the relationship of each to improved clinical outcomes. BENEFIT: The results will be used to develop policy to appropriately classify practices as PCMHs and to inform reimbursement strategies for PCMHs based on patient outcomes. The work resulting from this study will provide an understanding of the correlation between the current tool intended to recognize clinical practices at patient-centered medical homes (PCMHs) and the evidenced-based features of primary care and patient outcomes. The results will inform policymakers on the utility of the current PCMH recognition tool in appropriately classifying practices as PCMHs and inform payers on the utility of the current tool in identifying practices with better patient outcomes