| Autor: |
Ginting ML; Geriatric Education and Research Institute, Singapore 768024, Singapore., Wong CH; Geriatric Education and Research Institute, Singapore 768024, Singapore.; Tsao Foundation, Singapore 168730, Singapore.; Health Services & Systems Research, Duke-NUS, Singapore 169857, Singapore., Lim ZZB; Geriatric Education and Research Institute, Singapore 768024, Singapore., Choo RWM; Geriatric Education and Research Institute, Singapore 768024, Singapore., Carlsen SCH; Geriatric Education and Research Institute, Singapore 768024, Singapore., Sum G; Geriatric Education and Research Institute, Singapore 768024, Singapore., Vrijhoef HJM; Panaxea, B.V., 1098 XH Amsterdam, The Netherlands.; Department of Patient & Care, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands. |
| Abstrakt: |
Patient-Centred Medical Home (PCMH) is a strategy to enhance patient-centredness to improve care experience. We aimed to understand patient experience of an integrated PCMH model for complex community-dwelling older adults in Singapore. We used a mixed-method design with a prospective single-group pre-post quantitative component and a concurrent qualitative component. Participants were administered the validated Consumer Assessment of Health Providers and Systems Clinician & Group Survey (CG-CAHPS) at baseline (N = 184) and 6-month (N = 166) post-enrolment. We conducted focus group discussions (FGDs) on a purposive sample of 24 participants. Both methods suggest better care experience in PCMH relative to usual care. There were improvements in the CG-CAHPS measures on patient-provider communication, care coordination, office staff interactions, support for patients in caring for their own health, and provider rating in PCMH relative to usual care. In the FGDs, participants reported benefits of consolidated appointments and positive experience in sustained patient-provider relationship, shared-decision making, and family/caregiver engagement in PCMH. Participants may not fully comprehend the concept of integrated care, hindering both the effective communication of the intended care model and perceived benefits such as the provision of multidisciplinary team-based care. |
