Health Services Research

Cover image for Vol. 49 Issue 4

Edited By: Jacqueline S. Zinn and Patrick S. Romano

Impact Factor: 2.291

ISI Journal Citation Reports © Ranking: 2012: 13/67 (Health Policy & Services); 22/83 (Health Care Sciences & Services)

Online ISSN: 1475-6773

Virtual Issue: Preliminary Evidence on the Impact of Patient-Centered Medical Home Implementation


Preliminary Evidence on the Impact of Patient-Centered Medical Home Implementation

Avedis Donabedian first articulated the concepts of structure, process and outcome quality in his seminal 1980 writings (Donabedian 1980). Structural quality measures describe the tangible characteristics of the health care setting, process measures consider the technical and interpersonal interaction between provider and patient, and outcome measures evaluate the end result of health care, e.g., subsequent health status following an episode of care. What has come to be known as the Structure/Process/Outcome (SPO) model has a predictive as well as a descriptive component, in that good structure and process should lead to better outcomes. The patient-centered medical home can be considered in the context of the SPO model as it embraces both structural (e.g., capacity and capability) and process (e.g., care pathways) elements designed to enhance the outcomes of care: quality, safety and satisfaction. However, evidence based assessments of its impact on outcomes has been relatively limited. The studies compiled here have a common theme in that they provide preliminary evidence of the extent to which the structures and processes incorporated into the patient-centered medical home concept have influenced care outcomes. Their collective findings may shed light on where additional research on this topic would be useful and provide initial guidance for policy initiatives.

Comparative Effectiveness of Standard versus Patient-Centered Collaborative Care Interventions for Depression among African Americans in Primary Care Settings: The BRIDGE Study
Lisa A. Cooper, Bri K. Ghods Dinoso, Daniel E. Ford, Debra L. Roter, Annelle B. Primm, Susan M. Larson, James M. Gill, Gary J. Noronha, Elias K. Shaya and Nae-Yuh Wang

The Patient-Centered Medical Home and Patient Experience
Grant R. Martsolf, Jeffrey A. Alexander, Yunfeng Shi, Lawrence P. Casalino, Diane R. Rittenhouse, Dennis P. Scanlon, Stephen M. Shortell

Using Fuzzy Set Qualitative Comparative Analysis (fs/QCA) to Explore the Relationship between Medical “Homeness” and Quality
Nels Marcus Thygeson, Leif I. Solberg, Stephen E. Asche, Patricia Fontaine, Leonard Gregory Pawlson, Sarah Hudson Scholle

An Assessment of Patient-Based and Practice Infrastructure–Based Measures of the Patient-Centered Medical Home: Do We Need to Ask the Patient?
Bradley Michael Gray, Weifeng Weng, Eric S. Holmboe

Mortality among Patients with Acute Myocardial Infarction: The Influences of Patient-Centered Care and Evidence-Based Medicine
Mark Meterko,, Steven Wright, Hai Lin, Elliott Lowy, Paul D. Cleary

Interpersonal Processes of Care Survey: Patient-Reported Measures for Diverse Groups
Anita L. Stewart, Anna M. Nápoles-Springer, Steven E. Gregorich, Jasmine Santoyo-Olsson

Physician Practices and Readiness for Medical Home Reforms: Policy, Pitfalls, and Possibilities
John M. Hollingsworth, Sanjay Saint, Joseph W. Sakshaug, Rodney A. Hayward, Lingling Zhang, David C. Miller

Association of Experiences of Medical Home Quality with Health-Related Quality of Life and School Engagement among Latino Children in Low-Income Families
Gregory D. Stevens, Christina Vane, Michael R. Cousineau

Reference: Donabedian, A. 1980. Exploration in quality assessment and monitoring. Volume I. The definition of quality and approaches to its assessment. Chicago: Health Administration Press.

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