Principles of the patient-centered medical home and preventive services delivery

Authors, Primary Ferrante,J. M.;Balasubramanian,B. A.;Hudson,S. V.;Crabtree,B. F.
Title Primary Principles of the patient-centered medical home and preventive services delivery
Periodical Full Annals of Family Medicine
Pub Year 2010
Volume 8
issue 2
Start Page 108-116
Abstract 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.
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Place of Publication Not Available
Author/Address Department of Family Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. ferranjm@umdnj.edu; Publisher URL: www.cinahl.com/cgi-bin/refsvc?jid=3206&accno=2010591349
PubMed Link
Reference Type(s) Journal Article
Topic Tag(s) Patient-Centered Care;Care Coordination;Health Information Technology;Defining/Evaluating/Qualifying a Medical Home;Outcomes
Special Population(s) Not Available
Case Study No
Commentary/Opinion Piece No
Historical Publication No
Key/Foundational Article No
Literature Review Yes
Article Rating No
Summary of Article Rating No