Defining and measuring the patient-centered medical home

Kurt C. Stange, Paul A. Nutting, William L. Miller, Carlos R. Jaén, Benjamin F. Crabtree, Sue Flocke, James M. Gill

Research output: Contribution to journalReview article

325 Citations (Scopus)

Abstract

The patient-centeredmedical home(PCMH) is four things: 1) the fundamental tenets of primary care: first contact access, comprehensiveness, integration/coordination, and relationships involving sustained partnership; 2) new ways of organizing practice; 3) development of practices' internal capabilities, and 4) related health care system and reimbursement changes. All of these are focused on improving the health of whole people, families, communities and populations, and on increasing the value of healthcare. The value of the fundamental tenets of primary care is well established. This value includes higher health care quality, better whole-person and population health, lower cost and reduced inequalities compared to healthcare systems not based on primary care. The needed practice organizational and health care system change aspects of the PCMH are still evolving in highly related ways. The PCMH will continue to evolve as evidence comes in from hundreds of demonstrations and experiments ongoing around the country, and as the local and larger healthcare systems change. Measuring the PCMH involves the following: &Giving primacy to the core tenets of primary care &Assessing practice and system changes that are hypothesized to provide added value &Assessing development of practices' core processes and adaptive reserve &Assessing integration with more functional healthcare system and community resources &Evaluating the potential for unintended negative consequences from valuing the more easily measured instrumental features of the PCMH over the fundamental relationship and whole system aspects &Recognizing that since a fundamental benefit of primary care is its adaptability to diverse people, populations and systems, functional PCMHs will look different in different settings. Efforts to transform practice to patient-centered medical homes must recognize, assess and value the fundamental features of primary care that provide personalized, equitable health care and foster individual and population health.

Original languageEnglish (US)
Pages (from-to)601-612
Number of pages12
JournalJournal of general internal medicine
Volume25
Issue number6
DOIs
StatePublished - Jun 1 2010
Externally publishedYes

Fingerprint

Patient-Centered Care
Primary Health Care
Delivery of Health Care
Population
Quality of Health Care
Health
Health Care Costs

Keywords

  • Measurement
  • Patient-centered medical home
  • Primary care
  • Quality improvement

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Stange, K. C., Nutting, P. A., Miller, W. L., Jaén, C. R., Crabtree, B. F., Flocke, S., & Gill, J. M. (2010). Defining and measuring the patient-centered medical home. Journal of general internal medicine, 25(6), 601-612. https://doi.org/10.1007/s11606-010-1291-3

Defining and measuring the patient-centered medical home. / Stange, Kurt C.; Nutting, Paul A.; Miller, William L.; Jaén, Carlos R.; Crabtree, Benjamin F.; Flocke, Sue; Gill, James M.

In: Journal of general internal medicine, Vol. 25, No. 6, 01.06.2010, p. 601-612.

Research output: Contribution to journalReview article

Stange, KC, Nutting, PA, Miller, WL, Jaén, CR, Crabtree, BF, Flocke, S & Gill, JM 2010, 'Defining and measuring the patient-centered medical home', Journal of general internal medicine, vol. 25, no. 6, pp. 601-612. https://doi.org/10.1007/s11606-010-1291-3
Stange, Kurt C. ; Nutting, Paul A. ; Miller, William L. ; Jaén, Carlos R. ; Crabtree, Benjamin F. ; Flocke, Sue ; Gill, James M. / Defining and measuring the patient-centered medical home. In: Journal of general internal medicine. 2010 ; Vol. 25, No. 6. pp. 601-612.
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