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批准了“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，将各种做法确认为PCMH。该工具强调以信息技术为重点的实践结构。目前还不清楚，这些做法的结构与实际提供的初级保健的特点，PCMH的理论基础，或患者的结果。目得：该职业发展建议将1）检查PCMH识别工具与衡量初级保健循证特征的工具之间的相关性，以及2）确定每个工具的基础因素，以及3）评估PCMH识别工具与衡量初级保健循证特征的工具之间的相关性与临床结局。该项目将导致R 01应用程序开发一种改进的PCMH识别工具，将原始工具的元素与初级保健和改善的临床结果相结合。候选人：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的教学培训，2）将理论应用于卫生服务研究的应用，以确定当前PCMH识别工具的特征，这些特征与初级保健的循证特征和改善的临床结局相关。研究方法：研究方法包括NCQA PPC-PCMH和PCAT工具的总分和领域的相关性分析，每个工具的因素分析，以及每个工具与实践水平的临床结果的相关性。结果：结果包括更好地理解PCMH识别工具与初级保健属性的相关性以及每种属性与改善临床结果的关系。优点：研究结果将用于制定政策，以适当地将实践分类为PCMH，并根据患者结局为PCMH的报销策略提供信息。这项研究所产生的工作将提供一个现有的工具，旨在认识到在以病人为中心的医疗之家（PCMH）的临床实践和循证基础的初级保健和病人的结果之间的相关性的理解。结果将告知政策制定者当前PCMH识别工具在将实践适当分类为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局的实践方面的效用

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