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患者为中心的医疗之家对医疗差异的影响:探索利益相关者对当前标准和未来方向的看法。

The Impact of the Patient-Centered Medical Home on Health Care Disparities: Exploring Stakeholder Perspectives on Current Standards and Future Directions.

机构信息

1 University of California , San Francisco, San Francisco, California.

2 Institute of Health Policy and Management (iBMG), Erasmus University Rotterdam , the Netherlands .

出版信息

Popul Health Manag. 2019 Apr;22(2):99-107. doi: 10.1089/pop.2018.0055. Epub 2018 Jun 19.

Abstract

Over the past decade, the Patient-Centered Medical Home (PCMH) has become a preeminent model for primary care delivery. Simultaneously, health care disparities have gained increasing attention. There has been limited research on whether and how the PCMH can or should affect health care disparities. The authors conducted qualitative interviews with key stakeholders and experts on the PCMH model and health care disparities, including grant and policy makers, accreditors, researchers, patient advocates, primary care practices, practice transformation organizations, and payers, to assess perspectives on the role of the PCMH in addressing health care disparities. The application of grounded theory and thematic analysis elucidated best practice recommendations for the PCMH model's role in addressing health care disparities. Although the majority of stakeholders support greater integration of efforts to reduce health care disparities into the PCMH model, most stakeholders view the current PCMH model as having minimal or indirect influence on health care disparities. The majority supported greater integration of efforts to reduce health care disparities into the PCMH model. As the PCMH model continues to be refined, and as the health care system strives toward improving population health, there must be reflection on the policies and delivery systems that impact health care disparities.

摘要

在过去的十年中,以患者为中心的医疗之家(PCMH)已成为初级保健服务的卓越模式。与此同时,医疗保健差距也受到了越来越多的关注。关于 PCMH 是否以及如何能够或应该影响医疗保健差距的研究有限。作者对 PCMH 模式和医疗保健差距方面的主要利益相关者和专家进行了定性访谈,包括赠款和政策制定者、认证机构、研究人员、患者权益倡导者、初级保健实践、实践转型组织和支付方,以评估 PCMH 在解决医疗保健差距方面的作用的观点。扎根理论和主题分析的应用阐明了 PCMH 模型在解决医疗保健差距方面的最佳实践建议。尽管大多数利益相关者支持将减少医疗保健差距的努力更大程度地纳入 PCMH 模式,但大多数利益相关者认为当前的 PCMH 模式对医疗保健差距的影响最小或间接。大多数人支持将减少医疗保健差距的努力更大程度地纳入 PCMH 模式。随着 PCMH 模式的不断完善,以及医疗保健系统努力改善人口健康,必须反思影响医疗保健差距的政策和交付系统。

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