Medical home
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Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association Open
Complex environmental, social, behavioral, and emotional factors, known as psychosocial factors, influence living with diabetes, both type 1 and type 2, and achieving satisfactory medical outcomes and psychological well-being.Thus, individ…
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Association of Integrated Team-Based Care With Health Care Quality, Utilization, and Cost Open
Among adults enrolled in an integrated health care system, receipt of primary care at TBC practices compared with TPM practices was associated with higher rates of some measures of quality of care, lower rates for some measures of acute ca…
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Care Transitions From Patient and Caregiver Perspectives Open
Clear accountability, care continuity, and caring attitudes across the care continuum are important outcomes for patients and caregivers. When these outcomes are achieved, care is perceived as excellent and trustworthy. Otherwise, the care…
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Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities Open
Designing culturally sensitive personalized interventions is essential to sustain patients’ involvement in their treatment and encourage patients to take an active role in their own health and health care. We consider patient activation an…
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Home Health Care For Children With Medical Complexity: Workforce Gaps, Policy, And Future Directions Open
With the medical and surgical advances of recent decades, a growing proportion of children rely on home-based care for daily health monitoring and care tasks. However, a dearth of available home health care providers with pediatric trainin…
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The challenges of caring for children who require complex medical care at home: ‘The go between for everyone is the parent and as the parent that’s an awful lot of responsibility’ Open
Background Increasing numbers of children with complex health‐care needs are cared for at home by their family. The aim of this qualitative study was to explore the challenges experienced by families caring for children who need complex me…
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Child Health Disparities: What Can a Clinician Do? Open
Pediatric primary and specialty practice has changed, with more to do, more regulation, and more family needs than in the past. Similarly, the needs of patients have changed, with more demographic diversity, family stress, and continued he…
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Effects of a Medical Home and Shared Savings Intervention on Quality and Utilization of Care Open
During a 3-year period, this medical home intervention, which included shared savings for participating practices, was associated with relative improvements in quality, increased primary care utilization, and lower use of emergency departm…
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Housing, Transportation, And Food: How ACOs Seek To Improve Population Health By Addressing Nonmedical Needs Of Patients Open
Addressing nonmedical needs-such as the need for housing-is critical to advancing population health, improving the quality of care, and lowering the costs of care. Accountable care organizations (ACOs) are well positioned to address these …
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Medical-Legal Strategies to Improve Infant Health Care: A Randomized Trial Open
BACKGROUND: Changes in health care delivery create opportunities to improve systems to better meet the needs of low-income families while achieving quality benchmarks. METHODS: Families of healthy newborns receiving primary care at a singl…
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Association of Medical Scribes in Primary Care With Physician Workflow and Patient Experience Open
Medical scribes were associated with decreased physician EHR documentation burden, improved work efficiency, and improved visit interactions. Our results support the use of medical scribes as one strategy for improving physician workflow a…
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Neighborhood Child Opportunity and Individual-Level Pediatric Acute Care Use and Diagnoses Open
OBJECTIVES: Although health care providers and systems are increasingly interested in patients’ nonmedical needs as a means to improve health, little is known about neighborhood conditions that contribute to child health problems. We sough…
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Families’ Priorities Regarding Hospital-to-Home Transitions for Children With Medical Complexity Open
BACKGROUND: National health care policy recommends that patients and families be actively involved in discharge planning. Although children with medical complexity (CMC) account for more than half of pediatric readmissions, scalable, famil…
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The Pediatric Patient-Centered Medical Home: Innovative models for improving behavioral health. Open
This article examines the concept of the Patient-Centered Medical Home (PCMH) as it applies to children and adolescents, emphasizing care for behavioral health conditions, the role of psychology and psychological science, and next steps fo…
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Synthesis Of Research On Patient-Centered Medical Homes Brings Systematic Differences Into Relief Open
The patient-centered medical home (PCMH) model emphasizes comprehensive, coordinated, patient-centered care, with the goals of reducing spending and improving quality. To evaluate the impact of PCMH initiatives on utilization, cost, and qu…
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Parent Satisfaction With Communication Is Associated With Physician’s Patient-Centered Communication Patterns During Family Conferences* Open
Objectives: To evaluate the association between physician’s patient-centered communication patterns and parental satisfaction during decision-making family conferences in the PICU. Design: Single-site, cross-sectional study. Setting: Forty…
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“This Is How Hard It Is”. Family Experience of Hospital-to-Home Transition with a Tracheostomy Open
Rationale: Expansion of chronic ventilation options and shared decision-making have contributed to an increasing population of technology-dependent children. One particularly vulnerable group is children with tracheostomy who depend on tec…
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Genome Sequencing as a Diagnostic Test in Children With Unexplained Medical Complexity Open
This study suggests that genome sequencing has high analytical and clinical validity and can result in new diagnoses in CMC even in the setting of extensive prior investigations. This clinical population may be enriched for ultrarare and n…
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Parental perspectives of screening for adverse childhood experiences in pediatric primary care. Open
Parents want to discuss their ACEs and receive help and guidance from pediatricians. Furthermore, they perceive their child's pediatrician as having an important role to play in meeting their parenting goals. It is important to ensure that…
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Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care. Open
The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: compreh…
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Children with medical complexity: creating a framework for care based on the International Classification of Functioning, Disability and Health Open
Children with medical complexity ( CMC ) comprise a growing sector of the pediatric population. They are characterized by having severe chronic multiple system conditions, functional limitations, and family needs. While CMC comprise 0.4% t…
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Engaging multilevel stakeholders in an implementation trial of evidence-based quality improvement in VA women’s health primary care Open
The Veterans Health Administration (VHA) has undertaken primary care transformation based on patient-centered medical home (PCMH) tenets. VHA PCMH models are designed for the predominantly male Veteran population, and require tailoring to …
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The Inflammatory Bowel Disease Specialty Medical Home Open
New models of health care have emerged over the past decade. Accountable care organizations and patient-centered medical homes are designed to improve the patient experience, enhance health care quality, and decrease cost. These models hav…
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Parent Perspective on Care Coordination Services for Their Child with Medical Complexity Open
The overarching goal of care coordination is communication and co-management across settings. Children with medical complexity require care from multiple services and providers, and the many benefits of care coordination on health and pati…
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Facilitators and Barriers to Care Coordination in Patient-centered Medical Homes (PCMHs) from Coordinators' Perspectives Open
While all the barriers and facilitators were important to performing coordinators' roles, relationship building materialized as key to effective care coordination, whether with clinicians, patients, or outside organizations. We discuss imp…
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Upstream With A Small Paddle: How ACOs Are Working Against The Current To Meet Patients’ Social Needs Open
Despite interest in addressing social determinants of health to improve patient outcomes, little progress has been made in integrating social services with medical care. We aimed to understand how health care providers with strong motivati…
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Professional care at home: Patient‐centredness, interprofessionality and effectivity? A scoping review Open
The aim of this scoping review was to describe the state of knowledge on professional care at home with regard to different perspectives on patient-centredness, content of care, interprofessional collaboration, competence framework and eff…
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National Trends in Primary Care Visit Use and Practice Capabilities, 2008-2015 Open
From 2008 to 2015, primary care visits were longer, addressed more issues per visit, and were less likely to have scheduled follow-up for certain patients and conditions. Meanwhile, more PCPs offered non-face-to-face care. The decline in p…
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The Team Approach to Home‐Based Primary Care: Restructuring Care to Meet Individual, Program, and System Needs Open
Team‐based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address individual, program, and system needs, a portion of a large, physician‐…
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Integrating Behavioral Health into Primary Care Open
Depression is one of the more common diagnoses encountered in primary care, and primary care in turn provides the majority of care for patients with depression. Many approaches have been tried in efforts to improve the outcomes of depressi…