Patient-Centered Medical Home Recognition and Clinical Performance in U.S. Community Health Centers

Health Serv Res. 2017 Jun;52(3):984-1004. doi: 10.1111/1475-6773.12523. Epub 2016 Jun 20.

Abstract

Introduction: America's community health centers (HCs) are uniquely poised to implement the patient-centered medical home (PCMH) model, as they are effective in providing comprehensive, accessible, and continuous primary care. This study aims to evaluate the relationship between PCMH recognition in HCs and clinical performance.

Methods: Data for this study came from the 2012 Uniform Data System (UDS) as well as a survey of HCs' PCMH recognition achievement. The dependent variables included all 16 measures of clinical performance collected through UDS. Control measures included HC patient, provider, and practice characteristics. Bivariate analyses and multiple logistic regressions were conducted to compare clinical performance between HCs with and without PCMH recognition.

Findings: Health centers that receive PCMH recognition generally performed better on clinical measures than HCs without PCMH recognition. After controlling for HC patient, provider, and practice characteristics, HCs with PCMH recognition reported significantly better performance on asthma-related pharmacologic therapy, diabetes control, pap testing, prenatal care, and tobacco cessation intervention.

Conclusion: This study establishes a positive association between PCMH recognition and clinical performance in HCs. If borne out in future longitudinal studies, policy makers and practices should advance the PCMH model as a strategy to further enhance the quality of primary care.

Keywords: Patient-centered medical home; clinical performance; community health centers; quality of care; vulnerable population.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Asthma / drug therapy
  • Clinical Competence*
  • Community Health Centers* / economics
  • Diabetes Mellitus / therapy
  • Hospitals
  • Humans
  • Patient-Centered Care / economics
  • Patient-Centered Care / organization & administration*
  • Prenatal Care
  • Primary Health Care / economics
  • Primary Health Care / standards*
  • Quality of Health Care
  • Surveys and Questionnaires