Organizational Processes and Patient Experiences in the Patient-centered Medical Home
| Autor: | Jaya Aysola, Marilyn M. Schapira, Hairong Huo, Rachel M. Werner |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Medical home MEDLINE Article 03 medical and health sciences 0302 clinical medicine Patient satisfaction Nursing Residence Characteristics Patient-Centered Care Surveys and Questionnaires Health care Humans 030212 general & internal medicine Quality of Health Care Primary Health Care business.industry Extramural 030503 health policy & services Public Health Environmental and Occupational Health Patient-centered care United States Organizational processes Outcome and Process Assessment Health Care Socioeconomic Factors Patient Satisfaction Female 0305 other medical science Psychology business Patient centered |
| Zdroj: | Medical Care. 56:497-504 |
| ISSN: | 0025-7079 |
| DOI: | 10.1097/mlr.0000000000000910 |
| Popis: | BACKGROUND: There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. OBJECTIVE: Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care RESEARCH DESIGN: We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system. We evaluated the associations between practice organizational processes and patient experience using generalized estimating equations (GEE) with an exchangeable correlation structure to account for patient clustering by practice in multivariate models, adjusting for several practice-level and patient-level characteristics. We evaluated if these associations varied by race/ethnicity, insurance type, and the degree of patient comorbidity MEASURES: Predictors include overall PCMH adoption and adoption of six organizational processes: access and communications, patient tracking and registry, care management, test referral tracking, quality improvement and external coordination. Primary outcome was overall patient experience. RESULTS: In our full sample, overall PCMH adoption score was not significantly associated with patient experience outcomes. However, among subpopulations with higher comorbidities, the overall PCMH adoption score was positively associated with overall patient experience measures [0.2 (0.06, 0.4); p=0.006]. Differences by race/ethnicity and insurance type in associations between specific organizational processes and patient experience were noted. CONCLUSION: While some organizational processes relate to patients’ experiences with care irrespective of the background of the patient, further efforts are needed to align practice efforts with patient experience. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|