title: Medical home characteristics and the pediatric patient experience.
abstract: BACKGROUND
  The patient-centered medical home (PCMH) has roots in pediatrics, yet we know little about the experience of pediatric patients in PCMH settings.
  
  
  OBJECTIVE
  To examine the association between clinic PCMH characteristics and pediatric patient experience as reported by parents.
  
  
  METHODS
  We assessed the cross-sectional correlation between clinic PCMH characteristics and pediatric patient experience in 24 clinics randomly selected from the Safety Net Medical Home Initiative, a 5-state PCMH demonstration project. PCMH characteristics were measured with surveys of randomly selected providers and staff; surveys generated 0 (worst) to 100 (best) scores for 5 subscales, and a total score. Patient experience was measured through surveying parents of pediatric patients. Questions from the Consumer Assessment of Healthcare Providers and Systems-Clinician and Group instrument produced 4 patient experience measures: timeliness, physician communication, staff helpfulness, and overall rating. To investigate the relationship between PCMH characteristics and patient experience, we used generalized estimating equations with an exchangeable correlation structure.
  
  
  RESULTS
  We included 440 parents and 214 providers and staff in the analysis. Total PCMH score was not associated with parents' assessment of patient experience; however, PCMH subscales were associated with patient experience in different directions. In particular, quality improvement activities undertaken by clinics were strongly associated with positive ratings of patient experience, whereas patient care management activities were associated with more negative reports of patient experience.
  
  
  CONCLUSIONS
  Future work should bolster features of the PCMH that work well for patients while investigating which PCMH features negatively impact patient experience, to yield a better patient experience overall.
authors.affiliation: *Section of General Internal Medicine, Departments of Medicine and Pediatrics University of Chicago †Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL ‡Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Deborah
authors.initials: D
authors.lastname: Burnet
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Gunter
authors.forename: Robert S
authors.initials: RS
authors.lastname: Nocon
authors.forename: Yue
authors.initials: Y
authors.lastname: Gao
authors.forename: Janel
authors.initials: J
authors.lastname: Jin
authors.forename: Paige
authors.initials: P
authors.lastname: Fairchild
authors.forename: Marshall H
authors.initials: MH
authors.lastname: Chin
mesh_terms: D001291:Attitude of Health Personnel; D003120:Colorado; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006801:Humans; D007061:Idaho; D008404:Massachusetts; D009922:Oregon; D018802:Patient-Centered Care / Q000458:organization & administration*; D010372:Pediatrics / Q000458:organization & administration*; D010414:Pennsylvania; D011216:Practice Management, Medical / Q000458:organization & administration*; D015397:Program Evaluation / Q000379:methods*; D064876:Safety-net Providers / Q000458:organization & administration*