McHugh Megan, Shi Yunfeng, Ramsay Patricia P, Harvey Jillian B, Casalino Lawrence P, Shortell Stephen M, Alexander Jeffrey A
Megan McHugh (
Yunfeng Shi is an assistant professor in the Department of Health Policy and Administration at Pennsylvania State University, in University Park.
Health Aff (Millwood). 2016 Jan;35(1):141-9. doi: 10.1377/hlthaff.2015.0495.
To improve health care quality within communities, increasing numbers of multistakeholder alliances-groups of payers, purchasers, providers, and consumers-have been created. We used data from two rounds (conducted in July 2007-March 2009 and January 2012-November 2013) of a large nationally representative survey of small and medium-size physician practices. We examined whether the adoption of patient-centered medical home processes spread more rapidly in fourteen Robert Wood Johnson Foundation Aligning Forces for Quality communities, where multistakeholder health care alliances promoted their use, than in other communities. We found no difference in the overall growth of adoption of the processes between the two types of communities. However, improvement on a care coordination subindex was 7.17 percentage points higher in Aligning Forces for Quality communities than in others. Despite the enthusiasm for quality improvement led by multistakeholder alliances, such alliances may not be a panacea for spreading patient-centered medical home processes across a community.
为提高社区内的医疗保健质量，越来越多的多方利益相关者联盟——由支付方、采购方、医疗服务提供者和消费者组成的团体——应运而生。我们使用了对中小型医生诊所进行的两轮全国性代表性大型调查的数据（第一轮于2007年7月至2009年3月进行，第二轮于2012年1月至2013年11月进行）。我们研究了以患者为中心的医疗之家流程在14个罗伯特·伍德·约翰逊基金会质量联盟社区（多方利益相关者医疗保健联盟促进其使用）中传播的速度是否比在其他社区更快。我们发现，这两类社区在采用这些流程的总体增长方面没有差异。然而，质量联盟社区在护理协调子指数上的改善比其他社区高7.17个百分点。尽管多方利益相关者联盟对质量改进充满热情，但此类联盟可能并非在整个社区推广以患者为中心的医疗之家流程的万灵药。
