Is access to and use of primary care practices that patients perceive as having essential qualities of a patient-centered medical home associated with positive patient experience? Empirical evidence from a U.S. Nationally representative sample

Academic Article

Abstract

  • Objective: The patient-centered medical home (PCMH) has emerged as an innovative healthcare delivery model that holds the conceptual promise to improve healthcare quality and patient experience. This study examined how patient perceived PCMH is related to patient satisfaction and experience nationwide. This study advances academic discussion in that it is among the first to examine empirical evidence using a U.S. nationally representative sample. Methods: This retrospective cohort study used data from the 2010 to 2011 Medical Expenditure Panel Survey. This study focused on insured individuals aged 18 and older. We measured and identified cohorts for a "full PCMH," a "partial PCMH" (i.e., with a usual source of care but not a PCMH), and an "unknown PCMH," with the reference group being the "no regular provider" group and the partial PCMH group, respectively. Using logit models, we assessed patient experiences of the PCMH use controlling for covariates in 2010. Given the nature of the complex survey design, the weights and variance were adjusted using the survey procedures to yield nationally representative results. Results: The final study sample consisted of 7,743 individuals, representing 191 million individuals in the weighted population. After controlling for covariates in 2010, the full PCMH group was consistently observed to have higher odds of positive patient experience than individuals with no usual source of care: odds ratio (OR) = 1.89 (p = .003) for providers "listened carefully to you"; OR = 1.81 (p = .001) for providers "spent enough time with you";OR = 1.85 (p = .007) for providers "showed respect forwhatyouhadtosay";andOR=1.89(p<.001) for thecomposite patient experience. Similarly, compared with the partial PCMH group, consistently higher odds of patient satisfaction among all patient experience measures were observed for the fullmedical home group: OR = 1.45 (p = .070, significant at a = 0.1 level) for providers "explained things so you understood";OR = 1.69 (p = .002) for providers "listened carefully to you"; OR= 1.57 (p = .003) for providers "spent enough time with you";OR = 1.48 (p=.039) forproviders"showedrespect forwhatyouhadtosay";andOR= 1.56 (p = .001) for the composite patient experience. Conclusions: Overall, the PCMH model was associated with improved patient satisfaction nationwide. Findings from this study have shed light on strategies of innovative healthcare delivery models in improving patient experience, which in turn, may translate to patients'compliance to treatment regimen andimprovedhealth outcomes. Copyright 201 National Association for Healthcare Quality.
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    Digital Object Identifier (doi)

    Author List

  • Xin H; Kilgore ML; Sen BP
  • Start Page

  • 4
  • End Page

  • 14
  • Volume

  • 39
  • Issue

  • 1