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DePuccio, Matthew J.; Hoff, Timothy

doi:10.1097/qmh.0000000000000000

Cited by 15 publications

(28 citation statements)

References 32 publications

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“…The medical home is a practice model that includes a usual source of care, provides case management or care coordination services, if needed, and focuses on patients as partners in the health decision‐making process. By emphasizing communication between the provider and the patient at a level and in a language that is understandable for the patient, this model encourages patients to take more responsibility for their own health, leading to better health outcomes [6]…”

Section: Introductionmentioning

confidence: 99%

“…Switching was more common among patients who talked with their physician about generics[34] or spoke on the phone or via e‐mail with a pharmacy benefits manager [20,35]. More effective communication between providers and patients may also lower costs[18,36] and may be enhanced by the use of electronic medical records,[37] a key component in the PCMH [6]. To our knowledge, no study has examined the role of the medical home model in switching behaviour.…”

Section: Introductionmentioning

confidence: 99%

“…Definitions of what constitutes a medical home differ somewhat, but most include the delivery of primary health care through a usual source of care (physician or facility), in a manner that is accessible, comprehensive, patient centred, integrated and/or coordinated, culturally appropriate, and that demonstrates a commitment to healthcare safety and quality [39]. There is considerable evidence in the literature that the PCMH model, when applied to patients with disabilities or chronic illness, saves money and improves both quality of care and patient outcomes [6,40]…”

Section: Introductionmentioning

confidence: 99%

“…By emphasizing communication between the provider and the patient at a level and in a language that is understandable for the patient, this model encourages patients to take more responsibility for their own health, leading to better health outcomes. [6] Clinician and patient concerns with risk and other issues associated with generic substitution are also well documented. [7][8][9] Clinicians most often mention the US Food and Drug…”

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confidence: 99%

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Influencing choice of branded or generic statins by older adults in the USA

Porterfield

Levin

Feigenbaum

2014

Journal of Pharmaceutical Health Services Research

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Objective This study examines whether information gained from face‐to‐face contact with health professionals has an influence on switching between branded and generic statins, a class of drugs primarily used by older adults. Methods Data from five panels of the Medical Expenditure Panel Study covering 2006–2011 are used to estimate multivariate logistic regression models examining whether statin switching is influenced by the patient‐centred medical home and type of pharmaceutical drug vendor. Key findings Provider consultation is important in consumer choice. Older adults who report their physician's office is ‘patient‐centred’ are more than twice as likely to make a generic to branded switch. Switching from branded to generic statins is 50% more likely when prescriptions are filled at a drugstore, 80% more likely when filling at another type of retail outlet and more than twice as likely when filling at a hospital‐based clinic (all places where it is possible to speak with a pharmacist in person) rather than filling through mail order or online. Free samples, dosage and type of insurance coverage also influence switching behaviour. Conclusions Communication between health providers and patients is an important part of the decision to switch between different statin formulations.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Influencing choice of branded or generic statins by older adults in the USA

Porterfield

Levin

Feigenbaum

2014

Journal of Pharmaceutical Health Services Research

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“…21,23,35 Given the variable manifestations inherent in the politics, economics, and organizational contexts of real-world primary care practice, 21,35,36 it is important to consider whether ideal transformation processes can be universally implemented and whether at this stage they can be evaluated with universally standardized measures. 23,33,[36][37][38][39][40][41][42] Furthermore, it is important to consider what constitutes a comprehensive set of ingredients for successful transformation and how to evaluate the processes contributing to its success. 4,43 To address these gaps, we set out to elucidate the domains and evaluation strategies that constitute a comprehensive methodology to determine how transformation occurs within the context of practice and to explain why such transformation happens.…”

Section: Introductionmentioning

confidence: 99%

Recommendations for a Mixed Methods Approach to Evaluating the Patient-Centered Medical Home

Goldman

Parker

Brown

et al. 2015

The Annals of Family Medicine

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PURPOSE There is a strong push in the United States to evaluate whether the patient-centered medical home (PCMH) model produces desired results. The explanatory and contextually based questions of how and why PCMH succeeds in different practice settings are often neglected. We report the development of a comprehensive, mixed qualitative-quantitative evaluation set for researchers, policy makers, and clinician groups. METHODSTo develop an evaluation set, the Brown Primary Care Transformation Initiative convened a multidisciplinary group of PCMH experts, reviewed the PCMH literature and evaluation strategies, developed key domains for evaluation, and selected or created methods and measures for inclusion. RESULTSThe measures and methods in the evaluation set (survey instruments, PCMH meta-measures, patient outcomes, quality measures, qualitative interviews, participant observation, and process evaluation) are meant to be used together. PCMH evaluation must be sufficiently comprehensive to assess and explain both the context of transformation in different primary care practices and the experiences of diverse stakeholders. In addition to commonly assessed patient outcomes, quality, and cost, it is critical to include PCMH components integral to practice culture transformation: patient and family centeredness, authentic patient activation, mutual trust among practice employees and patients, and transparency, joy, and collaboration in delivering and receiving care in a changing environment. CONCLUSIONSThis evaluation set offers a comprehensive methodology to enable understanding of how PCMH transformation occurs in different practice settings. This approach can foster insights about how transformation affects critical outcomes to achieve meaningful, patient-centered, high-quality, and cost-effective sustainable change among diverse primary care practices.

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Medical Home Implementation and Follow-Up of Cancer-Related Abnormal Test Results in the Veterans Health Administration

Rajan,

Sarvepalli,

Wei

et al. 2024

JAMA Netw Open

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ImportanceLack of timely follow-up of cancer-related abnormal test results can lead to delayed or missed diagnoses, adverse cancer outcomes, and substantial cost burden for patients. Care delivery models, such as the Veterans Affairs’ (VA) Patient-Aligned Care Team (PACT), which aim to improve patient-centered care coordination, could potentially also improve timely follow-up of abnormal test results. PACT was implemented nationally in the VA between 2010 and 2012.ObjectiveTo evaluate the long-term association between PACT implementation and timely follow-up of abnormal test results related to the diagnosis of 5 different cancers.Design, Setting, and ParticipantsThis multiyear retrospective cohort study used 14 years of VA data (2006-2019), which were analyzed using panel data-based random-effects linear regressions. The setting included all VA clinics and facilities. The participants were adult patients who underwent diagnostic testing related to 5 different cancers and had abnormal test results. Data extraction and statistical analyses were performed from September 2021 to December 2023.ExposureCalendar years denoting preperiods and postperiods of PACT implementation, and the PACT Implementation Progress Index Score denoting the extent of implementation in each VA clinic and facility.Main Outcome and MeasurePercentage of potentially missed timely follow-ups of abnormal test results.ResultsThis study analyzed 6 data sets representing 5 different types of cancers. During the initial years of PACT implementation (2010 to 2013), percentage of potentially missed timely follow-ups decreased between 3 to 7 percentage points for urinalysis suggestive of bladder cancer, 12 to 14 percentage points for mammograms suggestive of breast cancer, 19 to 22 percentage points for fecal tests suggestive of colorectal cancer, and 6 to 13 percentage points for iron deficiency anemia laboratory tests suggestive of colorectal cancer, with no statistically significant changes for α-fetoprotien tests and lung cancer imaging. However, these beneficial reductions were not sustained over time. Better PACT implementation scores were associated with a decrease in potentially missed timely follow-up percentages for urinalysis (0.3–percentage point reduction [95% CI, −0.6 to −0.1] with 1-point increase in the score), and laboratory tests suggestive of iron deficiency anemia (0.5–percentage point reduction [95% CI,−0.8 to −0.2] with 1-point increase in the score).Conclusions and RelevanceThis cohort study found that implementation of PACT in the VA was associated with a potential short-term improvement in the quality of follow-up for certain test results. Additional multifaceted sustained interventions to reduce missed test results are required to prevent care delays.

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Abstract: It would be advantageous for practices looking to align with patient-centered medical home quality and safety goals to consider the needs of older adults when redesigning care delivery.

Cited by 15 publications

References 32 publications

Influencing choice of branded or generic statins by older adults in the USA

Influencing choice of branded or generic statins by older adults in the USA

Recommendations for a Mixed Methods Approach to Evaluating the Patient-Centered Medical Home

Medical Home Implementation and Follow-Up of Cancer-Related Abnormal Test Results in the Veterans Health Administration

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