Department of Family Medicine, Madigan Army Medical Center, Tacoma, Washington, USA.
Department of Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Med Educ Online. 2022 Dec;27(1):2073806. doi: 10.1080/10872981.2022.2073806.
The Education-Centered Medical Home (ECMH) is a longitudinal clerkship where students provide care to patients at one clinic site for the entirety of medical school. Studies have demonstrated that ECMHs have higher completion rates of preventative measures than traditional student-run free clinics (SRFCs). However, data comparing ECMHs with licensed primary care provider clinics are limited. We performed a prospective chart review that examined vaccination and cancer screening rates of patients in an ECMH and those seen by primary care physicians (PCPs) at the same free clinic site. We then compared these groups with participants in the 2018 National Health Information Study (NHIS). A total of 62 ECMH patients, 3,515 PCP patients, and 25,045 NHIS participants were included in the study. Within the ECMH, 72.7% and 80.0% of patients were screened for breast and cervical cancer, respectively. These rates did not differ significantly from those of PCP patients or NHIS participants. While the percentage of ECMH patients screened for colon cancer was similar to that of PCP patients (78.9% vs. 65.8%, p = 0.09), it was proportionally greater than NHIS screening rates (78.9% vs. 63.3%, p = 0.043). In addition, the rate of influenza and pneumococcal pneumonia vaccination among ECMH patients (41.4% and 58.3%, respectively) did not differ significantly from the PCP and NHIS groups. Our study found that the ECMH model allows students to deliver preventative care comparable to licensed practitioners and national benchmarks. It reaffirms the ECMH as an effective method for students to provide high quality care to underserved patients.
以教育为中心的医疗之家（ECMH）是一种纵向实习，学生在整个医学院期间在一个诊所为患者提供护理。研究表明，ECMH 完成预防措施的比例高于传统的学生经营的免费诊所（SRFC）。然而，将 ECMH 与有执照的初级保健提供者诊所进行比较的数据有限。我们进行了一项前瞻性图表回顾，检查了在同一免费诊所就诊的 ECMH 患者和初级保健医生（PCP）患者的疫苗接种和癌症筛查率。然后，我们将这些组与 2018 年国家健康信息研究（NHIS）的参与者进行了比较。共有 62 名 ECMH 患者、3515 名 PCP 患者和 25045 名 NHIS 参与者纳入研究。在 ECMH 中，分别有 72.7%和 80.0%的患者接受了乳腺癌和宫颈癌筛查。这些比率与 PCP 患者或 NHIS 参与者的比率没有显著差异。虽然 ECMH 患者接受结肠癌筛查的百分比与 PCP 患者相似（78.9%比 65.8%，p = 0.09），但与 NHIS 筛查率相比，这一比例更高（78.9%比 63.3%，p = 0.043）。此外，ECMH 患者流感和肺炎球菌疫苗接种率（分别为 41.4%和 58.3%）与 PCP 和 NHIS 组无显著差异。我们的研究发现，ECMH 模式允许学生提供与有执照的从业者和国家基准相当的预防保健。它再次证实了 ECMH 是学生为服务不足的患者提供高质量护理的有效方法。
