Elements of the patient-centered medical home in family practices in Virginia.
OBJECTIVE
The patient-centered medical home (PCMH) is a widely accepted theory of a practice model to improve quality of care, patient satisfaction, and access to primary care services. This study explores existing elements of the PCMH and characteristics of family practices in Virginia.


METHODS
We developed and administered a survey questionnaire to capture information on practice characteristics and PCMH elements. We randomly sampled 700 family medicine offices in Virginia from a population of practices derived from the Virginia Board of Medicine Practitioner Information Database. We used a mixed-mode survey, allowing practices in the sample to respond by mail or Internet or at a regional family medicine conference.


RESULTS
The survey resulted in a response rate of 56%, with 342 office locations participating in the study. Most practices reported continuity-of-care processes (87%) and clinical guidelines (77%). Fewer reported use of patient surveys (48%), electronic medical record for internal coordination (38%), community linkages for care (31%), and clinical performance measurement (28%). A small number reported patient registries for multiple diseases (19%). Very few practices exhibited all elements outlined in the PCMH model (1%). Practice size (number of physicians) is significantly related to PCMH model alignment.


CONCLUSIONS
Most family practices in Virginia exhibit some elements of the PCMH model. Full implementation of the PCMH model is low. Baseline information on practice characteristics, prevalence of PCMH, and challenges of small practices should be considered in guiding efforts, evaluating progress, and developing policies for care model reform.
Goldberg
Debora Goetz
DG
Departments of Family Medicine and Health Administration, Virginia Commonwealth University, Richmond, Virginia, USA. goetzdc@vcu.edu
Kuzel
Anton J
AJ
D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000379:methods / Q000458:organization & administration*; D005194:Family Practice / Q000379:methods / Q000458:organization & administration* / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration; D018802:Patient-Centered Care / Q000379:methods / Q000458:organization & administration*; D011787:Quality of Health Care; D012044:Regression Analysis; D014768:Virginia