Akinci Fevzi, Patel Poonam M
Hosp Top. 2014 Oct-Dec;92(4):96-104. doi: 10.1080/00185868.2014.968493.
Despite the fact that the United States dedicates so much of its resources to healthcare, the current healthcare delivery system still faces significant quality challenges. The lack of effective communication and coordination of care services across the continuum of care poses disadvantages for those requiring long-term management of their chronic conditions. This is why the new transformation in healthcare known as the patient-centered medical home (PCMH) can help restore confidence in our population that the healthcare services they receive is of the utmost quality and will effectively enhance their quality of life. Healthcare using the PCMH model is delivered with the patient at the center of the transformation and by reinvigorating primary care. The PCMH model strives to deliver effective quality care while attempting to reduce costs. In order to relieve some of our healthcare system distresses, organizations can modify their delivery of care to be patient centered. Enhanced coordination of services, better provider access, self-management, and a team-based approach to care represent some of the key principles of the PCMH model. Patients that can most benefit are those that require long-term management of their conditions such as chronic disease and behavioral health patient populations. The PCMH is a feasible option for delivery reform as pilot studies have documented successful outcomes. Controversy about the lack of a medical neighborhood has created concern about the overall sustainability of the medical home. The medical home can stand independently and continuously provide enhanced care services as a movement toward higher quality care while organizations and government policy assess what types of incentives to put into place for the full collaboration and coordination of care in the healthcare system.
尽管美国将大量资源投入到医疗保健领域，但当前的医疗服务体系仍面临重大的质量挑战。在整个护理过程中，护理服务缺乏有效的沟通与协调，这给那些需要长期管理慢性病的人带来了不利影响。这就是为什么医疗保健领域新的转型模式——以患者为中心的医疗之家（PCMH）能够帮助民众恢复信心，相信他们所接受的医疗服务具有最高质量，并将切实提高他们的生活质量。采用PCMH模式的医疗保健以患者为转型核心，并通过重振初级保健来提供服务。PCMH模式在努力降低成本的同时，力求提供有效的高质量护理。为了缓解我们医疗体系的一些困境，医疗机构可以调整其护理服务，以患者为中心。加强服务协调、改善医疗服务提供者的可及性、自我管理以及基于团队的护理方法是PCMH模式的一些关键原则。最能从中受益的患者是那些需要对其病情进行长期管理的患者，如慢性病患者和行为健康患者群体。由于试点研究已证明取得了成功结果，PCMH是实现医疗服务改革的一个可行选择。关于缺乏医疗社区的争议引发了人们对医疗之家整体可持续性的担忧。医疗之家可以独立存在，并持续提供强化护理服务，朝着更高质量的护理迈进，同时各机构和政府政策评估应制定何种激励措施，以实现医疗体系中护理的全面协作与协调。
