TY - JOUR
AU - N. Pandhi
AU - J. E. DeVoe
AU - J. R. Schumacher
AU - C. Bartels
AU - C. T. Thorpe
AU - J. M. Thorpe
AU - M. A. Smith
A1 - 
AB - BACKGROUND: The patient-centered medical home (PCMH) concept recently has garnered national attention as a means of improving the quality of primary care. Preventive services are one area in which the use of a PCMH is hoped to achieve gains, though there has been limited exploration of PCMH characteristics that can assist with practice redesign. The purpose of this study was to examine whether first-contact access characteristics of a medical home (eg, availability of appointments or advice by telephone) confer additional benefit in the receipt of preventive services for individuals who already have a longitudinal relationship with a primary care physician at a site of care. METHODS: This was a secondary analysis examining data from 5507 insured adults with a usual physician who participated in the 2003 to 2006 round of the Wisconsin Longitudinal Study. Using logistic regression, we calculated the odds of receiving each preventive service, comparing individuals who had first-contact access with those without first-contact access. RESULTS: Eighteen percent of the sample received care with first-contact access. In multivariable analyses, after adjustment, individuals who had first-contact access had higher odds of having received a prostate examination (odds ratio [OR], 1.62; 95% CI, 1.20-2.18), a flu shot (OR, 1.36; 95% CI, 1.01-1.82), and a cholesterol test (OR, 1.36; 95% CI, 1.01-1.82) during the past year. There was no significant difference in receipt of mammograms (OR, 1.23; 95% CI, 0.94-1.61). CONCLUSIONS: In the primary care home, first-contact accessibility adds benefit, beyond continuity of care with a physician, in improving receipt of preventive services. Amid increasing primary care demands and finite resources available to translate the PCMH into clinic settings, there is a need for further studies of the interplay between specific PCMH principles and how they perform in practice.
BT - Journal of the American Board of Family Medicine : JABFM
C5 - Medical Home
CP - 4
CY - United States
DO - 10.3122/jabfm.2011.04.100254
IS - 4
JF - Journal of the American Board of Family Medicine : JABFM
N2 - BACKGROUND: The patient-centered medical home (PCMH) concept recently has garnered national attention as a means of improving the quality of primary care. Preventive services are one area in which the use of a PCMH is hoped to achieve gains, though there has been limited exploration of PCMH characteristics that can assist with practice redesign. The purpose of this study was to examine whether first-contact access characteristics of a medical home (eg, availability of appointments or advice by telephone) confer additional benefit in the receipt of preventive services for individuals who already have a longitudinal relationship with a primary care physician at a site of care. METHODS: This was a secondary analysis examining data from 5507 insured adults with a usual physician who participated in the 2003 to 2006 round of the Wisconsin Longitudinal Study. Using logistic regression, we calculated the odds of receiving each preventive service, comparing individuals who had first-contact access with those without first-contact access. RESULTS: Eighteen percent of the sample received care with first-contact access. In multivariable analyses, after adjustment, individuals who had first-contact access had higher odds of having received a prostate examination (odds ratio [OR], 1.62; 95% CI, 1.20-2.18), a flu shot (OR, 1.36; 95% CI, 1.01-1.82), and a cholesterol test (OR, 1.36; 95% CI, 1.01-1.82) during the past year. There was no significant difference in receipt of mammograms (OR, 1.23; 95% CI, 0.94-1.61). CONCLUSIONS: In the primary care home, first-contact accessibility adds benefit, beyond continuity of care with a physician, in improving receipt of preventive services. Amid increasing primary care demands and finite resources available to translate the PCMH into clinic settings, there is a need for further studies of the interplay between specific PCMH principles and how they perform in practice.
PP - United States
PY - 2011
SN - 1557-2625; 1557-2625
SP - 351
EP - 359
EP - 
T1 - Preventive service gains from first contact access in the primary care home
T2 - Journal of the American Board of Family Medicine : JABFM
TI - Preventive service gains from first contact access in the primary care home
U1 - Medical Home
U2 - 21737759
U3 - 10.3122/jabfm.2011.04.100254
VL - 24
VO - 1557-2625; 1557-2625
Y1 - 2011
ER -