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的危机迫在眉睫。对初级保健医生的需求不断增加，加上报销率较低，使其在医疗行业中成为一个相对没有吸引力的职业。然而，研究表明，建立在初级保健基础上的保健系统具有较高的质量和较低的成本。以病人为中心的医疗之家（PCMH）的概念正在成为一种新的初级保健模式，可以缓解这些问题，同时促进一种以人口为基础，以病人和家庭为中心的护理模式，并超越了目前基于访问的报销制度的限制。PCMH的联合原则得到了许多专业医疗组织的支持，包括普通内科学会（SGIM），家庭医学教师学会（STFM）和学术儿科协会（阿帕）。为了广泛实施这一护理模式，决策者需要证据证明，通过护理协调提高质量和节省成本，增加获得预防性卫生保健的机会，以及改善慢性病管理，将抵消这一新的护理模式所需的任何增加的支出。 在乎这就需要一个卫生服务研究议程，这将有助于将PCMH从示范模式转变为基于证据的护理标准。因此，我们建议在2009年举办一次邀请会议，围绕PCMH制定一个与政策有关的研究议程。会议将召集国家研究人员，主要的初级保健专业组织，卫生保健购买者，支付者，患者倡导者和政策制定者。我们寻求资金以实现以下会议目标：1。告知和推进关于PCMH的艺术和科学以及真实的世界经验的状态; 2.发展伙伴关系和建设能力，以实施一个实用的评估模型，该模型可供卫生计划、政府付款人和政策制定者用于评估PCMH的组成部分和替代模型; 3.制定和建议研究议程，为PCMH模式的发展和广泛实施提供信息;以及4.通过同行评审的文献、网络以及在相关国家卫生政策和专业协会会议上的发言，传播会议的综合报告。

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.