以患者为中心的医疗之家在学校健康中心的衡量标准

Patient-Centered Medical Home Measurement in School-Based Health Centers.

作者信息

Gregg Abbey, Chen Li-Wu, Kim Jungyoon, Tak Hyo Jung, Tibbits Melissa

机构信息

1 Department of Community Medicine and Population Health, Institute for Rural Health Research, University of Alabama, Tuscaloosa, AL, USA.

2 Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, NE, USA.

出版信息

J Sch Nurs. 2019 Jun;35(3):189-202. doi: 10.1177/1059840517746728. Epub 2017 Dec 13.

DOI:10.1177/1059840517746728

PMID:29237335

Abstract

School-based health centers (SBHCs) have been suggested as potential medical homes, yet minimal attention has been paid to measuring their patient-centered medical home (PCMH) implementation. The purposes of this article were to (1) develop an index to measure PCMH attributes in SBHCs, (2) use the SBHC PCMH Index to compare PCMH capacity between PCMH certified and non-PCMH SBHCs, and (3) examine differences in index scores between SBHCs based in schools with and without adolescents. A total of six PCMH dimensions in the SBHC PCMH Index were identified through factor analysis. These dimensions were collapsed into two domains: care quality and comprehensive care. SBHCs recognized as PCMHs had higher scores on the index, both domains, and four dimensions. SBHCs based in schools with just young children and those with adolescents scored similarly on the overall index, but analysis of individual index items shows their strengths and weaknesses in PCMH implementation.

摘要

校本健康中心（SBHCs）被认为是潜在的医疗之家，但对其以患者为中心的医疗之家（PCMH）实施情况的衡量却很少受到关注。本文的目的是：（1）开发一个指数来衡量SBHCs中的PCMH属性；（2）使用SBHC PCMH指数比较获得PCMH认证的SBHCs和未获得认证的SBHCs之间的PCMH能力；（3）研究有青少年和没有青少年的学校中的SBHCs在指数得分上的差异。通过因子分析确定了SBHC PCMH指数中总共六个PCMH维度。这些维度被归纳为两个领域：护理质量和综合护理。被认可为PCMH的SBHCs在指数、两个领域以及四个维度上得分更高。只有幼儿的学校中的SBHCs和有青少年的学校中的SBHCs在总体指数上得分相似，但对个别指数项目的分析显示了它们在PCMH实施方面的优势和劣势。