title: Effects of Patient-centered Medical Home Transformation on Child Patient Experience.
abstract: BACKGROUND
  Patient experience, 1 of 3 aims for improving health care, is rarely included in studies of patient-centered medical home (PCMH) transformation. This study examines the association between patient experience and National Committee on Quality Assurance (NCQA) PCMH transformation.
  
  
  METHODS
  This was a cross-sectional study of parent-reported child patient experience from PCMH and non-PCMH practices. It used randomly sampled experience surveys completed by 2599 patients at 29 pediatric and family medicine PCMH (n = 21) and non-PCMH (n = 8) practices in Vermont from 2011 to 2013. Patient experiences related to child development and prevention were assessed using the Consumer Assessment of Health care Providers and Systems (CAHPS).
  
  
  RESULTS
  A 10-point increase in NCQA score at PCMH practices is associated with a 3.1% higher CAHPS child prevention score (P = .004). Among pediatric practices, PCMH recognition is associated with 7.7% (P < .0005) and 7.2% (P < .0005) higher CAHPS child development and prevention composite scores, respectively. Among family medicine practices, PCMH recognition is associated with 7.4% (P = .001) and 11.0% (P < .0005) lower CAHPS child development and prevention composite scores, respectively.
  
  
  CONCLUSIONS
  Our results suggest that PCMH recognition may improve child patient experience at pediatric practices and worsen experience at family medicine practices. These findings warrant further investigation into the differential influence of NCQA PCMH transformation on family medicine and pediatric practices.
authors.affiliation: From the Vermont Child Health Improvement Program (VCHIP), Department of Pediatrics (VSH, JK, RCW, JSS), and the Department of Psychiatry, University of Vermont, Burlington (VSH); and the Vermont Department of Health, Burlington (CJ). vharder@uvm.edu.
authors.forename: Valerie S
authors.initials: VS
authors.lastname: Harder
authors.affiliation: From the Vermont Child Health Improvement Program (VCHIP), Department of Pediatrics (VSH, JK, RCW, JSS), and the Department of Psychiatry, University of Vermont, Burlington (VSH); and the Vermont Department of Health, Burlington (CJ).
authors.forename: Julianne
authors.initials: J
authors.lastname: Krulewitz
authors.affiliation: From the Vermont Child Health Improvement Program (VCHIP), Department of Pediatrics (VSH, JK, RCW, JSS), and the Department of Psychiatry, University of Vermont, Burlington (VSH); and the Vermont Department of Health, Burlington (CJ).
authors.forename: Craig
authors.initials: C
authors.lastname: Jones
authors.affiliation: From the Vermont Child Health Improvement Program (VCHIP), Department of Pediatrics (VSH, JK, RCW, JSS), and the Department of Psychiatry, University of Vermont, Burlington (VSH); and the Vermont Department of Health, Burlington (CJ).
authors.forename: Richard C
authors.initials: RC
authors.lastname: Wasserman
authors.affiliation: From the Vermont Child Health Improvement Program (VCHIP), Department of Pediatrics (VSH, JK, RCW, JSS), and the Department of Psychiatry, University of Vermont, Burlington (VSH); and the Vermont Department of Health, Burlington (CJ).
authors.forename: Judith S
authors.initials: JS
authors.lastname: Shaw
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006801:Humans; D016014:Linear Models; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000458:organization & administration / Q000592:standards*; D010372:Pediatrics / Q000458:organization & administration / Q000592:standards*; D015397:Program Evaluation; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D014707:Vermont
keywords: Health Care Economics and Organizations; Patient-centered Care; Pediatrics