Marshall Robert C, Doperak Martin, Milner Michelle, Motsinger Charles, Newton Terry, Padden Maureen, Pastoor Sara, Hughes Cortney L, LeFurgy Jennifer, Mun Seong K
U.S. Navy Bureau of Medicine and Surgery, 2300 E Street NW, Washington, DC 20372, USA.
Mil Med. 2011 Nov;176(11):1253-9. doi: 10.7205/milmed-d-11-00109.
The patient-centered medical home (PCMH) is a primary care model that aims to provide quality care that is coordinated, comprehensive, and cost-effective. PCMH is hinged upon building a strong patient-provider relationship and using a team-based approach to care to increase continuity and access. It is anticipated that PCMH can curb the growth of health care costs through better preventative medicine and lower utilization of services. The Navy, Air Force, and Army are implementing versions of PCMH, which includes the use of technologies for improved documentation, better disease management, improved communication between the care teams and patients, and increased access to care. This article examines PCMH in the Military Health System by providing examples of the transition from each of the branches. The authors argue that the military must overcome unique challenges to implement and sustain PCMH that civilian providers may not face because of the deployment of patients and staff, the military's mission of readiness, and the use of both on-base and off-base care by beneficiaries. Our objective is to lay out these considerations and to provide ways that they have been or can be addressed within the transition from traditional primary care to PCMH.
以患者为中心的医疗之家（PCMH）是一种初级保健模式，旨在提供协调、全面且具有成本效益的优质护理。PCMH基于建立牢固的医患关系，并采用团队协作的护理方法来增强连续性和可及性。预计PCMH可通过更好的预防医学和更低的服务利用率来抑制医疗保健成本的增长。海军、空军和陆军正在实施PCMH的不同版本，其中包括使用技术来改进文档记录、优化疾病管理、改善护理团队与患者之间的沟通以及增加医疗服务的可及性。本文通过提供各军种转型的实例，探讨军事卫生系统中的PCMH。作者认为，由于患者和工作人员的部署、军队随时待命的任务以及受益者对基地内和基地外医疗服务的使用，军队在实施和维持PCMH时必须克服一些民间医疗服务提供者可能不会面临的独特挑战。我们的目标是阐述这些考量因素，并提供在从传统初级保健向PCMH转型过程中已经或可以解决这些问题的方法。
