Medical Homes and Medical Practice
Using Fuzzy Set Qualitative Comparative Analysis (fs/QCA) to Explore the Relationship between Medical “Homeness” and Quality
Article first published online: 22 AUG 2011
© Health Research and Educational Trust
Health Services Research
Volume 47, Issue 1pt1, pages 22–45, February 2012
How to Cite
Marcus Thygeson, N., Solberg, L. I., Asche, S. E., Fontaine, P., Gregory Pawlson, L. and Scholle, S. H. (2012), Using Fuzzy Set Qualitative Comparative Analysis (fs/QCA) to Explore the Relationship between Medical “Homeness” and Quality. Health Services Research, 47: 22–45. doi: 10.1111/j.1475-6773.2011.01303.x
- Issue published online: 12 JAN 2012
- Article first published online: 22 AUG 2011
- Manuscript Accepted: 30 MAY 2011
- Agency for Healthcare Research and Quality. Grant Number: HHSA290 2007 10010 TO 4
- Bush Foundation
- National Commission on Quality Assurance
- Clinical practice systems;
- patient experience;
- quality of care;
- medical home;
- fuzzy set qualitative comparative analysis
Determine, using fuzzy set qualitative comparative analysis (fs/QCA), the relationship between patient-centered medical home (PCMH) systems and quality in 21 NCQA recognized medical homes.
Data Sources/Study Setting
Primary data collected in 2009, including measures of optimal diabetes care (ODC), preventive services up-to-date (PSUTD), patient experience (PEX), survey data assessing PCMH capabilities (PPC-RS), and other clinic characteristics.
Cross-sectional study identifying associations between PPC-RS domains, demographic, socioeconomic, and co-morbidity measures, and quality outcomes.
Data Collection/Extraction Methods
PPC-RS scores were obtained by surveying clinic leaders. PSUTD and ODC scores were obtained from provider performance data. PEX data were obtained from patient surveys. Demographic, socioeconomic, and co-morbidity data were obtained from EMR and census data.
fs/QCA identified associations between all three outcomes and PCMH capabilities: ODC and team-based care; PSUTD and preventive services systems; and all three outcomes and provider performance reporting systems. Previous statistical analysis of this data had failed to identify these relationships.
fs/QCA identified important associations that were overlooked using conventional statistics in a small-N health services data set. PCMH capabilities are associated with quality outcomes.