The Group Health Medical Home At Year Two: Cost Savings, Higher Patient Satisfaction, And Less Burnout For Providers

Reid, Robert J.; Coleman, Katie; Johnson, Eric A.; Fishman, Paul; Hsu, Clarissa; Soman, Michael; Trescott, Claire; Erikson, Michael; Larson, Eric B.

doi:10.1377/hlthaff.2010.0158

Cited by 488 publications

(404 citation statements)

References 16 publications

(14 reference statements)

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“…Further, we are unable to be certain that every hospitalization that an enrolled subject had during the study period was captured within our available data. Although the potential generalizability of this study may be limited by having been conducted in a single healthcare system, it is important to note that GHC had implemented programmatic interventions to reduce hospitalizations during the 5-year follow-up period, 49,50 suggesting that the magnitude of the association we found between probable major depression and hospitalizations for ACSCs-could be even greater. Finally, the possibility of residual confounding remains as in any observational study.…”

Section: Discussionmentioning

confidence: 99%

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

et al. 2013

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BACKGROUND: Hospitalizations for ambulatory caresensitive conditions (ACSCs), conditions that should not require inpatient treatment if timely and appropriate ambulatory care is provided, may be an important contributor to rising healthcare costs and public health burden. OBJECTIVE: To examine if probable major depression is independently associated with hospitalization for an ACSC in patients with diabetes. DESIGN: Secondary analysis of data from a prospective cohort study. PARTICIPANTS: Population-based cohort of 4,128 patients with diabetes ≥ 18 years old seen in primary care, who were enrolled between 2000 and 2002 and followed for 5 years (through 2007). MAIN MEASURES: Depressive symptoms were assessed with the Patient Health Questionnaire-9. Outcomes of interest included time to initial hospitalization for an ACSC and total number of ACSC-related hospitalizations. We used Cox proportional hazards regression models to ascertain an association between probable major depression and time to ACSC-related hospitalization, as well as Poisson regression for models examining probable major depression and number of ACSC-related hospitalizations. KEY RESULTS: Patients' mean age at study enrollment was 63.4 years (Standard Deviation: 13.4 years). Over the 5-year follow-up period, 981 patients in the study were hospitalized a total of 1,721 times for an ACSC, comprising 45.1 % of all hospitalizations. After adjusting for baseline demographic, clinical and health-risk behavioral factors, probable major depression was associated with initial ACSC-related hospitalization (Hazard Ratio: 1.41, 95 % Confidence Interval [95 % CI]: 1.15, 1.72) and number of ACSC-related hospitalizations (Relative Risk: 1.37, 95 % CI: 1.12, 1.68). CONCLUSIONS: Probable major depression in patients with diabetes is independently associated with hospitalization for an ACSC. Additional research is warranted to ascertain if effective interventions for depression in patients with diabetes could reduce the risk of hospitalizations for ACSCs and their associated adverse outcomes.

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Section: Discussionmentioning

confidence: 99%

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

et al. 2013

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“…In fact, evidence supports the association of greater clinician satisfaction with enhanced organizational performance, with a clearly positive return on investment for efforts to promote physician satisfaction. 5 Integration of the Quadruple Aim into current healthcare initiatives may be aided by consideration of five key drivers of physician satisfaction: i) work effort, ii) work efficiency and support, iii) management of work-home interference, iv) flexibility and control at work, and v) values and meaning in work. These drivers have been well characterized in the literature, 6 and offer a template for areas on which organizations might focus attention.…”

mentioning

confidence: 99%

Physician Well-Being: Expanding the Triple Aim

West

2016

J GEN INTERN MED

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“…PCMH models have been associated with improvements in patient satisfaction and provider burnout, as well as more modest changes in clinical outcomes [2–7]. One of the most common PCMH certifications is through the National Center for Quality Assurance (NCQA) Recognition Program, which is nearing the end of its first decade, having been established in 2008.…”

Section: Introductionmentioning

confidence: 99%

Do medical residents perform patient-centered medical home tasks? A mixed-methods study

Block

LaVine

Verbsky

et al. 2017

Medical Education Online

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Background: Increasingly, residents are being trained in Patient-centered Medical Home (PCMH) settings. A set of PCMH entrustable professional activities (EPAs) for residents has been defined but not evaluated in practice. Objective: To understand whether residents trained at PCMH sites reported higher likelihood of engaging in PCMH tasks than those training in non-PCMH sites. Design: Survey and nominal group data from post-graduate trainees at three residency programs. Results: A total of 179 residents responded (80% response). Over half (52%) cared for patients at PCMH sites. Residents at PCMH sites were more likely to report engaging in tasks in the NCQA domains of enhancing access and continuity (p < 0.01 for 4/11 tasks), planning and managing care (p < 0.01 for 3/4 tasks), providing self-care and community support (p < 0.01 for 3/5 tasks), and identifying and managing patient populations (p < 0.01 for 1/6 tasks), but were not more likely to report tracking and coordinating care or measuring and improving performance. Residents at PCMH sites were more likely to report working with medical assistants (p < 0.01), but not other healthcare professionals. Qualitative data showed staff teamwork and continuity of care as facilitators of patient-centered care, and technological problems and office inefficiencies as barriers to care. Conclusions: Residents trained at PCMH sites were more likely to engage in tasks in several NCQA domains, but not care coordination and quality assessment. Similar facilitators and barriers to trainee provision of patient-centered care were cited regardless of PCMH status. Curricula on PCMH principles and workflows that foster continuity and communication may help to inform residents on PCMH tenets and incorporate residents into team-based care. Abbreviations: EPA: Entrustable professional activity; GIM: General Internal Medicine; NCQA: National Center for Quality Assurance; PCMH: Patient-centered medical home

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The Group Health Medical Home At Year Two: Cost Savings, Higher Patient Satisfaction, And Less Burnout For Providers

Cited by 488 publications

References 16 publications

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

Physician Well-Being: Expanding the Triple Aim

Do medical residents perform patient-centered medical home tasks? A mixed-methods study

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