Effects of patient-centered medical home attributes on patients' perceptions of quality in federally supported health centers.
OBJECTIVE
We sought to assess patients' ratings of patient-centered medical home (PCMH) attributes and overall quality of care within federally supported health centers.


METHODS
Data were collected through the 2009 Health Center Patient Survey (n = 4,562), which consisted of in-person interviews and included a nationally representative sample of patients seen in health centers. Quality measures included patients' perceptions of overall quality of services, perceptions of quality of clinician advice/treatment, and likelihood of referring friends and relatives to the health center. PCMH attributes included (1) access to care getting to health center, (2) access to care during visit, (3) patient-centered communication with health care clinicians, (4) patient-centered communication with support staff, (5) self-management support for chronic conditions, (6) self-management support for behavioral risks, and (7) comprehensive preventive care. Bivariate analysis and logistic regressions were used to examine associations between patients' perceptions of PCMH attributes and patient-reported quality of care.


RESULTS
Eighty-four percent of patients reported excellent/very good overall quality of services, 81% reported excellent/very good quality of clinician care, and 84% were very likely to refer friends and relatives. Higher patient ratings on the access to care and patient-centered communication attributes were associated with higher odds of patient-reported high quality of care on the 3 outcome measures.


CONCLUSIONS
More than 80% of patients perceived high quality of care in health centers. PCMH attributes related to access to care and communication were associated with greater likelihood of patients reporting high-quality care.
Office of Research and Evaluation, Office of Planning, Analysis and Evaluation, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland.
Lydie A
LA
Lebrun-Harris
Leiyu
L
Shi
Jinsheng
J
Zhu
Matthew T
MT
Burke
Alek
A
Sripipatana
Quyen
Q
Ngo-Metzger
D000328:Adult; D001294:Attitude to Health; D003142:Communication; D003151:Community Health Centers / Q000191:economics / Q000592:standards*; D005163:Factor Analysis, Statistical; D035082:Federal Government; D005260:Female; D005380:Financing, Government / Q000191:economics; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011314:Preventive Health Services / Q000592:standards; D011785:Quality Assurance, Health Care; D012648:Self Care / Q000592:standards; D011795:Surveys and Questionnaires; D014481:United States
health care quality assessment; patient-centered care; primary care; vulnerable populations