The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context
| Autor: | Chen Hee Tam, Elaine Qiao Ying Ho, Shilpa Surendran, David B. Matchar, Josip Car, Gerald Choon-Huat Koh, Chuan De Foo |
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| Přispěvatelé: | Lee Kong Chian School of Medicine (LKCMedicine), Centre for Population Health Sciences |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Health
Toxicology and Mutagenesis Patient-Centered Medical Home lcsh:Medicine Context (language use) Locale (computer software) Pharmacy Primary care family medicine clinic Grounded theory Article 03 medical and health sciences primary care 0302 clinical medicine general practitioners Revenue Medicine [Science] 030212 general & internal medicine Primary Care business.industry 030503 health policy & services lcsh:R Public Health Environmental and Occupational Health patient-centered medical home Public relations Scale (social sciences) qualitative Business 0305 other medical science Patient centered policy |
| Zdroj: | International Journal of Environmental Research and Public Health International Journal of Environmental Research and Public Health, Vol 18, Iss 1817, p 1817 (2021) Volume 18 Issue 4 |
| ISSN: | 1660-4601 1661-7827 |
| Popis: | In recent years, there is growing interest internationally to implement patient-centered medical homes (PCMHs), and Singapore is no exception. However, studies understanding the influence of contextual policy factors on the implementation of PCMHs are limited. We conducted 10 semi-structured in-depth interviews with general practitioners working in seven out of the nine PCMHs. Audio recordings were transcribed and analyzed by two study team members in NVivo 12 Software using grounded theory techniques. Power dynamics between the stakeholders and lack of shared decision-making among them in selecting the locale of the PCMH and formulating the practice fee and pharmacy structure were the key factors which negatively affected the implementation of PCMHs on a larger scale. Over time, lack of funding to hire dedicated staff to transfer patients and misalignment of various stakeholders’ interest to other right-siting programs also resulted in low number of patients with chronic conditions and revenue. Countries seeking to implement a successful PCMH may benefit from building trust and relationship between stakeholders, engaging in shared decision-making, ongoing cost-efficiency efforts, and formulating a clear delineation of responsibilities between stakeholders. For a healthcare delivery model to succeed in the primary care landscape, policies should be developed keeping mind the realities of primary care practice. Ministry of Health (MOH) National Medical Research Council (NMRC) Published version This research was funded by the National Medical Research Council (NMRC) and Ministry of Health, Singapore, Health Service Research Grant (HSRG), grant number NMRC/HSRG/0086/2018 and the Centre Grant Program Singapore Population Health Improvement Centre, grant number: NMRC/CG/C026/2017_NUHS. |
| Databáze: | OpenAIRE |
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