title: Supporting Medical Home Transformation Through Evaluation of Patient Experience in a Large Culturally Diverse Primary Care Safety Net.
abstract: BACKGROUND
  The prevalence of chronic disease in the United States is rapidly increasing, with a disproportionate number of underserved, vulnerable patients sharing the burden. The Patient-Centered Medical Home (PCMH) is a care delivery model that has shown promise to improve primary care and address the burden of chronic illness.
  
  
  OBJECTIVE
  The purpose of this study was to (1) understand patient characteristics that might influence perceived patient experience in a large primary care safety net undergoing PCMH transformation; (2) identify community-level quality improvement opportunities to support ongoing transformation activities; and (3) establish a baseline of patient experience across the primary care safety net that could be used in repeated evaluations over the course of transformation.
  
  
  METHODS
  A cross-sectional study design was used to conduct this research.
  
  
  METHODS
  A total of 351 racially and ethnically diverse patients of 4 primary care safety net organizations in Broward County, Florida, were surveyed regarding their experience with access to care and coordination of care.
  
  
  METHODS
  Reported access to care and coordination of care.
  
  
  RESULTS
  Patients with chronic disease who reported having visited the clinic 3 or more times in the past 12 months reported a better coordination of care experience than patients who had fewer than 3 visits in the past 12 months (odds ratio = 3.57; 95% confidence interval, 1.76-7.24). Patients without chronic disease who had been receiving care at the clinic for 2 or more years of care reported worse experience with access to care than patients with less than 2 years of care (odds ratio = 0.26; 95% confidence interval, 0.11-0.60.) Race, ethnicity, language, and education were not significant predictors of patient experience.
  
  
  CONCLUSIONS
  Findings support ongoing efforts to improve patient engagement among all patients and to enhance resources to manage chronic disease, including community-based self-management programs, in primary care safety nets undergoing PCMH transformation.
authors: Master of Public Health Program, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida (Drs Cook, Hollar, and Peterson); ICF International, Atlanta, Georgia (Dr Zunker); and Broward Regional Health Planning Council, Hollywood, Florida (Ms Phillips and Mr De Lucca).
authors: Nicole
authors: N
authors: Cook
authors: T Lucas
authors: TL
authors: Hollar
authors: Christie
authors: C
authors: Zunker
authors: Michael
authors: M
authors: Peterson
authors: Teina
authors: T
authors: Phillips
authors: Michael
authors: M
authors: De Lucca
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D002908:Chronic Disease / Q000208:ethnology / Q000628:therapy*; D003430:Cross-Sectional Studies; D018864:Cultural Diversity; D005260:Female; D005431:Florida; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration; D064876:Safety-net Providers / Q000458:organization & administration*; D012959:Socioeconomic Factors