Review of patient-reported experience within Patient-Centered Medical Homes: insights for Australian Health Care Homes

Understanding patient experience is necessary to advance the patient-centred approach to health service delivery. Australia’s primary healthcare model, the ‘Health Care Home’, is based on the ‘Patient-Centered Medical Home’ (PCMH) model developed in the United States. Both these models aim to improve patient experience; however, the majority of existing PCMH model evaluations have focussed on funding, management and quality assurance measures. This review investigated the scope of evidence reported by adult patients using a PCMH. Using a systematic framework, the review identified 39 studies, sourced from 33 individual datasets, which used both quantitative and qualitative approaches. Patient experience was reported for model attributes, including the patient–physician and patient–practice relationships; care-coordination; access to care; and, patient engagement, goal setting and shared decision-making. Results were mixed, with the patient experience improving under the PCMH model for some attributes, and some studies indicating no difference in patient experience following PCMH implementation. The scope and quality of existing evidence does not demonstrate improvement in adult patient experience when using the PCMH. Better measures to evaluate patient experience in the Australian Health Care Home model are required.

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Kulana Hawai'i: A Culturally Adapted Weight Management Program in a Patient-Centered Health Care Home

PsycEXTRA Dataset ◽

10.1037/e604152013-001 ◽

2013 ◽

Author(s):

Ayda A. Austin ◽

Andrea Hermosura

Keyword(s):

Health Care ◽

Weight Management ◽

Care Home ◽

Management Program ◽

Weight Management Program ◽

Patient Centered ◽

Culturally Adapted ◽

Health Care Home

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Hawai‘i Patient-Centered Health Care Home Project: A Collaborative Partnership between Four Hawai‘i Federally Qualified Health Centers, AlohaCare, and the Hawai‘i Primary Care Association

AAPI Nexus Policy Practice and Community ◽

10.17953/appc.12.1-2.3554380158r15252 ◽

2014 ◽

Vol 12 (1-2) ◽

pp. 119-139

Author(s):

Mary Frances Oneha ◽

Robert Hirokawa ◽

Cristina Vocalan

Keyword(s):

Primary Care ◽

Health Care ◽

Care Home ◽

Health Centers ◽

Collaborative Partnership ◽

Federally Qualified Health Centers ◽

Patient Centered ◽

Care Association ◽

Health Care Home

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Abstract 002: Patient Provider Communication and Patient-centered Outcomes Among Patients With Atherosclerotic Cardiovascular Disease in United States: Medical Expenditure Panel Survey 2010-2013

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.002 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Victor Okunrintemi ◽

Erica Spatz ◽

Joseph Salami ◽

Haider Warraich ◽

Salim Virani ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Medical Expenditure Panel Survey ◽

Medical Expenditure ◽

Atherosclerotic Cardiovascular Disease ◽

Care Providers ◽

Patient Centered ◽

Patient Reported ◽

Centered Care ◽

Nationally Representative

Background: With recent enactment of Accountable Care Act, consumer reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey (CAHPS) in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD). Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. Participants responded to questions from CAHPS that assess satisfaction with PPC (four-point response scale: never, sometimes, usually, always ) :(1) “How often providers show respect for what you had to say” (2) “How often health care providers listened carefully to you” (3) “How often health care providers explained things so you understood” (4) “How often health providers spent enough time with you” We developed a weighted PPC composite score, categorized as 1 ( never / sometimes ), 2 ( usually ), and 3 ( always ). Outcomes of interest were 1) patient reported outcomes (PRO): SF-12 physical/mental health status, 2) quality of care measures: statin and ASA use, 3) health-care resource utilization (HRU): Emergency room visits & hospital stays, 4) total annual and out of pocket healthcare expenditures (HCE). Results: As shown in the table, those with ASCVD reporting ineffective (never/sometimes) vs. effective PCC (always) were over 2-fold more likely to report poor PRO, 34% & 22% less likely to report statin and ASA use respectively, had a significantly greater HRU (OR≥ 2 ER visit: 1.40 [95% CI:1.09-1.80], OR≥ 2 hospitalization: 1.35 [95% CI:1.02-1.77], as well as an estimated $1,294 ($121-2468) higher annual HCE. Conclusion: This study reveals a strong relationship between patient-physician communication among those with established ASCVD with patient-reported outcomes, utilization of evidence based therapies, healthcare resource utilization and expenditures.

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Feasibility of Goal Attainment Scaling in Chronic Low Back Pain: Protocol for Training & Implementation in an Outpatient Physical Therapy Setting (Preprint)

10.2196/preprints.32457 ◽

2021 ◽

Author(s):

Douglas Haladay ◽

Rebecca Edgeworth Ditwiler ◽

Aimee Klein ◽

Rebecca Miro ◽

Matthew Lazinski ◽

...

Keyword(s):

Physical Therapy ◽

Clinical Setting ◽

Goal Attainment ◽

Physical Therapists ◽

The United States ◽

Goal Attainment Scaling ◽

Low Back ◽

Patient Centered ◽

Patient Reported ◽

Qualitative Phase

BACKGROUND Patient engagement in decisions regarding their healthcare may lead to improved outcomes and improved adherence to treatment plans. While there are several options for involving patients in their healthcare, goal setting is a readily accessible method for physical therapists to increase the involvement of patients in healthcare decisions. Physical therapy goals are often provider-generated and based on subjective information or standardized fixed-item patient-reported outcome measures. However, these outcome measures may provide a limited scope of activity and participation limitations which may not capture the needs of individual patients. Goal Attainment Scaling (GAS) is a patient-centered approach to involving patients in setting meaningful goals. While GAS has been shown to be reliable, valid, and sensitive to change in various population, there is limited evidence in the United States about utilizing GAS in the physical therapist management of patients with low back pain (LBP). OBJECTIVE The purpose of this report is to describe the protocol for a study to a) develop an application of GAS procedures to be used by physical therapists treating patients with chronic LBP in the United States and b) to test the feasibility of applying GAS procedures in chronic LBP in an outpatient physical therapy setting. METHODS This study will use a mixed-methods design with two (2) phases (Phase 1: Qualitative, Phase 2: Quantitative). The qualitative phase of the study will employ focus groups of patients with chronic LBP to identify an inventory of goals that are important and measurable. This inventory will be used to develop a series of leading questions that will allow physical therapists to assist patients in establishing goals in the clinical setting. The quantitative phase of the study will pilot-test the inventory developed in the qualitative arm in patients with chronic LBP to determine feasibility, reliability, validity, and responsiveness. We will also compare how well GAS captures change over time as compared to traditional fixed-item patient-reported measures. RESULTS We anticipate that this study will demonstrate that GAS can be implemented successfully by outpatient physical therapists, and it will demonstrate clinically important changes that are important to patients with chronic LBP. CONCLUSIONS GAS represents an opportunity for patient-centered care in the physical therapy management of chronic LBP. While GAS is not new, it has never been studied in a real-world clinical setting for the physical therapy management of chronic LBP which have unique time and productivity constraints. For GAS to be successfully implemented in this environment, we must demonstrate that clinicians can be trained efficiently and reliably, that GAS can be implemented in the clinical setting in under 15 minutes, and that GAS is able to detect clinically meaningful change in patient outcomes. CLINICALTRIAL N/A

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Trends in the Contribution of Emergency Departments to the Provision of Hospital-Associated Health Care in the USA

International Journal of Health Services ◽

10.1177/0020731417734498 ◽

2017 ◽

Vol 48 (2) ◽

pp. 267-288 ◽

Cited By ~ 30

Author(s):

David Marcozzi ◽

Brendan Carr ◽

Aisha Liferidge ◽

Nicole Baehr ◽

Brian Browne

Keyword(s):

United States ◽

Health Care ◽

Medical Care ◽

Emergency Departments ◽

The United States ◽

National Hospital ◽

Patient Centered ◽

National Hospital Discharge Survey ◽

Delivery Of Care ◽

The Usa

Traditional approaches to assessing the health of populations focus on the use of primary care and the delivery of care through patient-centered homes, managed care resources, and accountable care organizations. The use of emergency departments (EDs) has largely not been given consideration in these models. Our study aimed to determine the contribution of EDs to the health care received by Americans between 1996 and 2010 and to compare it with the contribution of outpatient and inpatient services using National Hospital Ambulatory Medical Care Survey and National Hospital Discharge Survey databases. We found that EDs contributed an average of 47.7% of the hospital-associated medical care delivered in the United States, and this percentage increased steadily over the 14-year study period. EDs are a major source of medical care in the United States, especially for vulnerable populations, and this contribution increased throughout the study period. Including emergency care within health reform and population health efforts would prove valuable to supporting the health of the nation.

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‘We can work together, talk together’: an Aboriginal Health Care Home

Australian Health Review ◽

10.1071/ah18107 ◽

2018 ◽

Cited By ~ 1

Author(s):

Greg Smith ◽

Renae Kirkham ◽

Charlie Gunabarra ◽

Valda Bokmakarray ◽

C. Paul Burgess

Keyword(s):

Health Care ◽

Care Home ◽

Aboriginal Health ◽

Health Care Home

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Cultivating Connection: The Magic of Attuning, Wondering, Following & Holding

COJ Nursing & Healthcare ◽

10.31031/cojnh.2018.02.000529 ◽

2018 ◽

Vol 2 (1) ◽

Author(s):

Ann Flanagan Petry

Keyword(s):

Health Care ◽

Patient Experience ◽

Nursing Care ◽

Interpersonal Relations ◽

Care Delivery ◽

Employee Attitudes ◽

Patient Centered ◽

Caring Relationships ◽

Award Winning ◽

And Performance

Remember what drew you to health care? And what makes your work meaningful now? Chances are caring for people is the answer to both questions. In fact, healthcare is provided through relationships. Over a decade ago we developed a care delivery framework described in the award-winning book Relationship-Based Care: A Model for Transforming Practice. We were on the vanguard of a revolution toward more patient-centered caring. Indeed, we have always known the importance of connection to patient experience, employee attitudes, interpersonal relations, teams and performance. For nurses, caring relationships are so essential at work that it is inseparable from the work itself. We believe the best nursing care requires understanding of three key relationships: A. Relationship to one’s self, B. Relationship to co-workers and C. Relationship to patients and families. And, the hallmark of meaningful connection is attunement or tuning-in to others with genuine interest and care.

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