scholarly journals Association of the Implementation of the Patient-Centered Medical Home with Quality of Life in Patients with Multimorbidity

2019 ◽  
Vol 35 (1) ◽  
pp. 119-125 ◽  
Author(s):  
Linnaea Schuttner ◽  
Ashok Reddy ◽  
Ann-Marie Rosland ◽  
Karin Nelson ◽  
Edwin S. Wong
Keyword(s):  
Quality Of Life ◽  
Medical Home ◽  
Patient Centered Medical Home ◽  
Patient Centered

scholarly journals Impact of a patient-centered medical home demonstration on quality of life and patient activation for older adults with complex needs in Singapore

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Grace Sum ◽  
Soon Hoe Ho ◽  
Zoe Zon Be Lim ◽  
Junxing Chay ◽  
Mimaika Luluina Ginting ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Home ◽  
Statistical Significance ◽  
Patient Activation ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Needs Satisfaction ◽  
The Impact ◽  
Eq Vas

Abstract Background The first Patient-Centered Medical Home (PCMH) demonstration in Singapore was launched in November 2016, which aimed to deliver integrated and patient-centered care for patients with bio-psycho-social needs. Implementation was guided by principles of comprehensiveness, coordinated care, shared decision-making, accessible services, and quality and safety. We aimed to investigate the impact of implementing the PCMH in primary care on quality of life (QoL) and patient activation. Methods The study design was a prospective single-arm pre-post study. We applied the 5-level EuroQol 5-dimension (EQ-5D-5L) and Visual Analog Scale (EQ VAS) instruments to assess health-related QoL. The CASP-19 tool was utilised to examine the degree that needs satisfaction was fulfilled in the domains of Control, Autonomy, Self-realisation, and Pleasure. The 13-item Patient Activation Measure (PAM-13) was used to evaluate knowledge, skills and confidence in management of conditions and ability to self-care. Multivariable linear regression models with random intercepts were applied to examine the impact of the PCMH intervention on outcome measures at 3 months and 6 months post-enrolment, compared to baseline. Results We analysed 165 study participants enrolled into the PCMH from November 2017 to April 2020, with mean age 77 years (SD: 9.9). Within-group pre-post (6 months) EQ-5D-5L Index (β= -0.01, p-value = 0.35) and EQ VAS score (β=-0.03, p-value = 0.99) had no change. Compared to baseline, there were improvements in CASP-19 total score at 3 months (β = 1.34, p-value = 0.05) and 6 months post-enrolment (β = 1.15, p-value = 0.08) that were marginally out of statistical significance. There was also a significant impact of the PCMH on the CASP-19 Pleasure domain (β = 0.62, p = 0.03) at 6 months post-enrolment, compared to baseline. We found improved patient activation from a 15.2 % reduction in the proportion of participants in lower PAM levels, and a 23.4 and 16.7 % rise in proportion for higher PAM levels 3 and 4, respectively, from 3 months to 6 months post-enrolment. Conclusions Preliminary demonstration of the PCMH model shows evidence of improved needs satisfaction and patient activation, with potential to have a greater impact after a longer intervention duration.

scholarly journals Specialty Physician Designation in Referrals from a Vertically Integrated PCMH

2019 ◽  
Vol 6 ◽  
pp. 233339281985038
Author(s):  
Andrew D. Schreiner ◽  
Keri T. Holmes-Maybank ◽  
Jingwen Zhang ◽  
Justin Marsden ◽  
Patrick D. Mauldin ◽  
...  
Keyword(s):  
Medical Home ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Cross Sectional ◽  
Medical Specialties ◽  
The Individual

Introduction: Primary care referrals to specialty physicians once relied upon the medical skill of the specialist, the quality of past communication, and previous consultative experiences. As health systems vertically integrate, patterns of specialty physician referral designation are not known. Methods: This cross-sectional study from a patient-centered medical home (PCMH) evaluated the proportion of referrals with named specialists. All outpatient specialty referrals from the PCMH between July and December of 2014 were eligible for inclusion, and 410 patients were randomly selected for chart review. The outcome of interest was specialty physician designation. Other variables of interest included PCMH provider experience, the reason for referral, and time to specialty visit. Univariate analysis was performed with Fisher exact tests. Results: Of 410 specialty referrals, 43.7% were made to medical specialties, 41.7% to surgical specialties, and 14.6% to ancillary specialties. Resident physicians placed 224 referrals (54.6%), faculty physicians ordered 155 (37.8%), and advanced practice providers ordered 31 (7.6%). Only 11.2% of the specialty referral orders designated a specific physician. No differences appeared in the reason for referral, the referral destination, the proportion of visits scheduled and attended, or the time to schedule between those referrals with and without specialty physician designation. Faculty physicians identified a specific specialist in 21.4% of referrals compared to residents doing so in 4.9% ( P < .0001). Conclusion: Patient-centered medical home referrals named a specific specialty physician infrequently, suggesting a shift from the historical reliance on the individual characteristics of the specialist in the referral process.

Establishing the Role of the Pharmacist in the Patient-Centered Medical Home… The Opportunity is Now

2009 ◽  
Vol 25 (5) ◽  
pp. 287-291 ◽  
Author(s):  
Richard W Dettloff ◽  
Patricia Glosner ◽  
Susannah Motl Moroney
Keyword(s):  
Medical Home ◽  
Medical Setting ◽  
Patient Centered Medical Home ◽  
Coordinated Care ◽  
Patient Centered ◽  
Medication Therapy ◽  
Quality Of Patient Care ◽  
The Us ◽  
Care Coordinators

The patient-centered medical home (PCMH) is an approach to delivering comprehensive, continuous, coordinated care across all life stages and has been hypothesized to be one potential solution to the discrepancy between the high cost but low quality of health care in the US. Although a plethora of literature exists on how pharmacy interventions can improve the quality of patient care through medication therapy management programs, there is a paucity of data supporting pharmacists' involvement in PCMHs. Pharmacists are uniquely trained and positioned to make important contributions to PCMHs as medication care coordinators. The opportunity is now for pharmacists to establish their role within this medical setting.

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