An Assessment of Patient-Based and Practice Infrastructure-Based Measures of the Patient-Centered Me
Gray,Bradley Michael;Weng,Weifeng;Holmboe,Eric S.
An Assessment of Patient-Based and Practice Infrastructure-Based Measures of the Patient-Centered Medical Home: Do We Need to Ask the Patient?
Health services research
Objective To examine the importance of patient-based measures and practice infrastructure measures of the patient-centered medical home ( PCMH). Data Sources A total of 3,671 patient surveys of 202 physicians completing the American Board of Internal Medicine ( ABIM) 2006 Comprehensive Care Practice Improvement Module and 14,457 patient chart reviews from 592 physicians completing ABIM's 2007 Diabetes and Hypertension Practice Improvement Module. Methodology We estimated the association of patient-centered care and practice infrastructure measures with patient rating of physician quality. We then estimated the association of practice infrastructure and patient rating of care quality with blood pressure ( BP) control. Results Patient-centered care measures dominated practice infrastructure as predictors of patient rating of physician quality. Having all patient-centered care measures in place versus none was associated with an absolute 75.2 percent increase in the likelihood of receiving a top rating. Both patient rating of care quality and practice infrastructure predicted BP control. Receiving a rating of excellent on care quality from all patients was associated with an absolute 4.2 percent improvement in BP control. For reaching the maximum practice-infrastructure score, this figure was 4.5 percent. Conclusion Assessment of physician practices for PCMH qualification should consider both patient based patient-centered care measures and practice infrastructure measures.
Place of Publication
Patient-Centered Care;Defining/Evaluating/Qualifying a Medical Home;Evaluation Methods and Approaches;Outcomes