title: Elements of the patient-centered medical home associated with health outcomes among veterans: the role of primary care continuity, expanded access, and care coordination.
abstract: Care continuity, access, and coordination are important features of the patient-centered medical home model and have been emphasized in the Veterans Health Administration patient-centered medical home implementation, called the Patient Aligned Care Team. Data from more than 4.3 million Veterans were used to assess the relationship between these attributes of Patient Aligned Care Team and Veterans Health Administration hospitalization and mortality. Controlling for demographics and comorbidity, we found that continuity with a primary care provider was associated with a lower likelihood of hospitalization and mortality among a large population of Veterans receiving VA primary care.
authors.affiliation: VA Puget Sound Healthcare System, Northwest HSR&D Center of Excellence (Drs Nelson, Sun, Dolan, Maynard, Beste, and Bryson), VA Puget Sound Healthcare System, General Internal Medicine Service (Drs Nelson, Beste, Bryson, and Fihn), Department of Medicine, School of Medicine, University of Washington (Drs Nelson, Beste, Bryson and Fihn), Department of Health Services, School of Public Health, University of Washington (Dr Maynard), and VHA Office of Analytics and Business Intelligence (Dr Fihn), Seattle, Washington; and VHA Patient Care Services, Primary Care Program Office, Milwaukee, Wisconsin (Dr Schectman).
authors.forename: Karin
authors.initials: K
authors.lastname: Nelson
authors.forename: Haili
authors.initials: H
authors.lastname: Sun
authors.forename: Emily
authors.initials: E
authors.lastname: Dolan
authors.forename: Charles
authors.initials: C
authors.lastname: Maynard
authors.forename: Laruen
authors.initials: L
authors.lastname: Beste
authors.forename: Christopher
authors.initials: C
authors.lastname: Bryson
authors.forename: Gordon
authors.initials: G
authors.lastname: Schectman
authors.forename: Stephan D
authors.initials: SD
authors.lastname: Fihn
mesh_terms: D000368:Aged; D002423:Cause of Death; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D014481:United States; D014493:United States Department of Veterans Affairs