TY - JOUR
KW - Aged
KW - Analysis of Variance
KW - Cross-Sectional Studies
KW - Diagnostic Tests, Routine -- utilization
KW - Family Practice -- methods
KW - Family Practice -- statistics & numerical data
KW - Female
KW - Health Care Reform -- methods
KW - Health Promotion
KW - Humans
KW - Male
KW - Medical Records
KW - Middle Aged
KW - New Jersey
KW - Organizational Innovation
KW - Patient-Centered Care -- methods
KW - Physician-Patient Relations
KW - Preventive Health Services -- methods
KW - Preventive Health Services -- utilization
KW - Primary Health Care -- methods
KW - Questionnaires
KW - Randomized Controlled Trials as Topic
KW - United States
AU - J. M. Ferrante
AU - B. A. Balasubramanian
AU - S. V. Hudson
AU - B. F. Crabtree
A1 - 
AB - PURPOSE: Limited research exists examining the principles of the patient-centered medical home (PCMH) and improved outcomes. We examined whether PCMH principles (personal physician, physician-directed team, whole-person orientation, coordination of care, quality and safety, and enhanced access) are associated with receipt of preventive services. METHODS: We undertook cross-sectional analyses using baseline patient and practice member surveys and chart audits from a quality improvement trial in 24 primary care offices. Association of PCMH principles with preventive services (receipt of cancer screening, lipid screening, influenza vaccination, and behavioral counseling) was examined using hierarchical linear modeling. RESULTS: Higher global PCMH scores were associated with receipt of preventive services (beta = 2.3; P <.001). Positive associations were found with principles of personal physician (beta = 3.7; P <.001), in particular, continuity with the same physician (beta = 4.4; P = .002) and number of visits within 2 years (15% higher for patients with 13 or more visits; P <.001); and whole-person orientation (beta = 5.6; P <.001), particularly, having a well-visit within 5 years (beta = 12.3; P <.001) and being treated for chronic diseases (6% higher if more than 3 chronic diseases; P = .002). Having referral systems to link patients to community programs for preventive counseling (beta = 8.0; P <.001) and use of clinical decision-support tools (beta = 5.0; P = .04) were also associated with receipt of preventive services. CONCLUSIONS: Relationship-centered aspects of PCMH are more highly correlated with preventive services delivery in community primary care practices than are information technology capabilities. Demonstration projects and tools that measure PCMH principles should have greater emphasis on these key primary care attributes.
C5 - Medical Home
CP - 2
CY - United States
IS - 2
N2 - PURPOSE: Limited research exists examining the principles of the patient-centered medical home (PCMH) and improved outcomes. We examined whether PCMH principles (personal physician, physician-directed team, whole-person orientation, coordination of care, quality and safety, and enhanced access) are associated with receipt of preventive services. METHODS: We undertook cross-sectional analyses using baseline patient and practice member surveys and chart audits from a quality improvement trial in 24 primary care offices. Association of PCMH principles with preventive services (receipt of cancer screening, lipid screening, influenza vaccination, and behavioral counseling) was examined using hierarchical linear modeling. RESULTS: Higher global PCMH scores were associated with receipt of preventive services (beta = 2.3; P <.001). Positive associations were found with principles of personal physician (beta = 3.7; P <.001), in particular, continuity with the same physician (beta = 4.4; P = .002) and number of visits within 2 years (15% higher for patients with 13 or more visits; P <.001); and whole-person orientation (beta = 5.6; P <.001), particularly, having a well-visit within 5 years (beta = 12.3; P <.001) and being treated for chronic diseases (6% higher if more than 3 chronic diseases; P = .002). Having referral systems to link patients to community programs for preventive counseling (beta = 8.0; P <.001) and use of clinical decision-support tools (beta = 5.0; P = .04) were also associated with receipt of preventive services. CONCLUSIONS: Relationship-centered aspects of PCMH are more highly correlated with preventive services delivery in community primary care practices than are information technology capabilities. Demonstration projects and tools that measure PCMH principles should have greater emphasis on these key primary care attributes.
PP - United States
PY - 2010
SN - 1544-1709 (Print); 1544-1717 (Electronic)
SP - 108
EP - 116
EP - 
T1 - Principles of the patient-centered medical home and preventive services delivery
TI - Principles of the patient-centered medical home and preventive services delivery
U1 - Medical Home
U2 - 20212297
VL - 8
VO - 1544-1709 (Print); 1544-1717 (Electronic)
Y1 - 2010
ER -