TY - JOUR
KW - Cross-Sectional Studies
KW - Health Services Research
KW - Humans
KW - Patient Care Team/organization & administration
KW - Patient-Centered Care
KW - Primary Health Care/organization & administration
KW - Puerto Rico
KW - Rural Health Services/organization & administration
KW - United States
KW - United States Department of Veterans Affairs
KW - Urban Health Services/organization & administration
AU - V. Johnson
AU - E. Wong
AU - M. Lampman
AU - I. Curtis
AU - J. Fortney
AU - P. Kaboli
AU - S. Fihn
AU - K. Nelson
A1 - 
AB - Rural Veterans Health Administration (VHA) primary care clinics are smaller, have fewer staff, and serve more rural patients compared with urban VHA primary care clinics. This may lead to different challenges to implementation of the Patient-Centered Medical Home (PCMH) model, the Patient Aligned Care Team, in the VHAs' large integrated health system. In this cross-sectional observational study of 905 VHA primary clinics in the United States and Puerto Rico, we found overall PCMH implementation was greater in rural compared to urban primary care clinics. Urban-rural differences in PCMH implementation may largely be related to clinic organizational factors.
AD - Washington Permanente Medical Group, Seattle (Dr Johnson); Division of General Internal Medicine (Drs Fihn and Nelson) and Department of Health Services (Drs Wong and Fortney), University of Washington, Seattle; Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington (Drs Wong, Fortney, and Nelson); VHA Clinical Systems Development and Evaluation, Seattle, Washington (Dr Fihn and Ms Curtis); Center for Comprehensive Access and Delivery Evaluation at the Iowa City VA Health Care System, and Division of General Internal Medicine, University of Iowa, Iowa City (Dr Kaboli); and VISN 23 PACT Demonstration Lab, Iowa City and Mayo Clinic, Rochester MN (Dr Lampman).
BT - The Journal of ambulatory care management
C5 - Healthcare Disparities; Medical Home
CP - 1
CY - United States
DO - https://doi.org/10.1097/jac.0000000000000212
IS - 1
JF - The Journal of ambulatory care management
M1 - Journal Article
N2 - Rural Veterans Health Administration (VHA) primary care clinics are smaller, have fewer staff, and serve more rural patients compared with urban VHA primary care clinics. This may lead to different challenges to implementation of the Patient-Centered Medical Home (PCMH) model, the Patient Aligned Care Team, in the VHAs' large integrated health system. In this cross-sectional observational study of 905 VHA primary clinics in the United States and Puerto Rico, we found overall PCMH implementation was greater in rural compared to urban primary care clinics. Urban-rural differences in PCMH implementation may largely be related to clinic organizational factors.
PP - United States
PY - 2018
SN - 1550-3267; 0148-9917
SP - 47
EP - 57
EP - 
T1 - Comparing Patient-Centered Medical Home Implementation in Urban and Rural VHA Clinics: Results From the Patient Aligned Care Team Initiative
T2 - The Journal of ambulatory care management
TI - Comparing Patient-Centered Medical Home Implementation in Urban and Rural VHA Clinics: Results From the Patient Aligned Care Team Initiative
U1 - Healthcare Disparities; Medical Home
U2 - 28990992
U3 - https://doi.org/10.1097/jac.0000000000000212
VL - 41
VO - 1550-3267; 0148-9917
Y1 - 2018
Y2 - Jan/Mar
ER -