Patient-centered medical homes improve care for adults with chronic conditions.

Nadereh Pourat, Shana Alex Lavarreda, Sophie Snyder
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Abstract

The success of health care reform implementation in 2014 partly depends on more efficient delivery of care to the millions of California residents eligible to gain insurance. Emerging evidence supports the effectiveness of the patient-centered medical home (PCMH) as a potential model of care delivery, which improves health outcomes and reduces costs. Among other principles, PCMH entails receipt of care from a personal doctor, who coordinates the patient's care and develops an individualized treatment plan for the patient. These principles are particularly essential in delivery of care to those with chronic conditions who require more intensive care management. Using the 2009 California Health Interview Survey (CHIS 2009), this policy brief indicates that patients who reported meeting these fundamental PCMH principles were more likely to have visited the doctor and to have received flu shots, and they also had better communication with providers than those who did not report meeting these PCMH principles. The data also showed that uninsured individuals, Medi-Cal beneficiaries, those at or below 133% of the federal poverty level, Latinos, and Asian-Americans were less likely to report meeting all three PCMH principles. These findings highlight the population groups that would most benefit from the PCMH care delivery model, particularly Medi-Cal beneficiaries and those eligible for Covered California, the California health benefits exchange.

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以病人为中心的医疗之家改善了对患有慢性疾病的成年人的护理。
2014年医疗改革的成功实施部分取决于向数百万有资格获得保险的加州居民提供更有效的医疗服务。新出现的证据支持以患者为中心的医疗之家(PCMH)作为一种潜在的医疗服务模式的有效性,它可以改善健康结果并降低成本。在其他原则中,PCMH要求接受私人医生的护理,由私人医生协调患者的护理并为患者制定个性化的治疗计划。这些原则在向需要更多重症监护管理的慢性病患者提供护理时尤为重要。根据2009年加州健康访谈调查(CHIS 2009),该政策简报表明,报告符合这些PCMH基本原则的患者更有可能去看医生并接种流感疫苗,而且与没有报告符合这些PCMH原则的患者相比,他们与提供者的沟通也更好。数据还显示,没有保险的个人、加州医疗保险受益人、处于或低于联邦贫困线133%的人、拉丁美洲人和亚裔美国人不太可能报告满足所有三个PCMH原则。这些发现强调了从PCMH医疗服务模式中获益最多的人群,特别是Medi-Cal受益人和有资格参加Covered California(加州健康福利交易所)的人群。
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