title: Patient-centered medical home: how it affects psychosocial outcomes for diabetes.
abstract: Fragmentation of the current U.S. health care system and the increased prevalence of chronic diseases in the U.S. have led to the recognition that new models of care are needed. Chronic disease management, including diabetes, is often accompanied by a myriad of associated psychosocial issues that need to be addressed as part of a comprehensive treatment plan. Diabetes care should be aligned with comprehensive whole-person health care. The patient-centered medical home (PCMH) has emerged as a model for enhanced primary care that focuses on comprehensive integrated care. PCMH demonstration projects have shown improvements in quality of care, patient experience, care coordination, access to care, and quality measures for diabetes. Key PCMH transformative features associated with psychosocial issues related to diabetes reviewed in this article include integration of mental and behavioral health, care management/coordination, payment reform, advanced access, and putting the patient at the center of health care. This article also reviews the evidence supporting comprehensive and integrated care for addressing psychosocial issues associated with diabetes in the medical home.
authors.affiliation: Department of Family Medicine, University of Colorado School of Medicine, Mail Stop F496, AO1, 12631 E. 17th Ave., Room 3519, Aurora, CO 80045-0508, USA. bonnie.jortberg@ucdenver.edu
authors.forename: Bonnie T
authors.initials: BT
authors.lastname: Jortberg
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Miller
authors.forename: Robert A
authors.initials: RA
authors.lastname: Gabbay
authors.forename: Kerri
authors.initials: K
authors.lastname: Sparling
authors.forename: W Perry
authors.initials: WP
authors.lastname: Dickinson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000191:economics / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000191:economics / Q000523:psychology*; D005260:Female; D018166:Health Care Reform; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000191:economics / Q000458:organization & administration; D011320:Primary Health Care; D011787:Quality of Health Care; D016896:Treatment Outcome; D055815:Young Adult