title: Tool used to assess how well community health centers function as medical homes may be flawed.
abstract: The patient-centered medical home model holds the potential for reducing disease complications and improving health, and the federal government is now promoting the adoption of the model within federally qualified community health centers. In a group of Los Angeles community health centers, we found that all would have qualified as patient-centered medical homes under a widely used assessment tool developed by the National Committee for Quality Assurance and endorsed by the federal government for the community health center program. However, we also found that there was no significant relationship between how well these centers performed on the assessment and whether they achieved a range of process or outcome measures for diabetes care. These findings suggest that the federal government is promoting medical home redesign that may not be sensitive to, or inclusive of, services that will actually improve diabetes care for low-income patients. Therefore, additional methods are required for measuring and improving the capabilities of community health centers to function as medical homes and to deliver the scope of services that impoverished patients genuinely need.
authors.affiliation: David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA. rclarke@mednet.ucla.edu
authors.forename: Robin M A
authors.initials: RM
authors.lastname: Clarke
authors.forename: Chi-hong
authors.initials: CH
authors.lastname: Tseng
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brook
authors.forename: Arleen F
authors.initials: AF
authors.lastname: Brown
mesh_terms: D060866:Accountable Care Organizations; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003151:Community Health Centers / Q000592:standards*; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000592:standards*; D018802:Patient-Centered Care / Q000592:standards*; D011203:Poverty; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D012648:Self Care; D055815:Young Adult