title: Availability of Care Concordant With Patient-centered Medical Home Principles Among Those With Chronic Conditions: Measuring Care Outcomes.
abstract: BACKGROUND
  Care delivery redesign in the form of patient-centered medical home (PCMH) is considered as a potential solution to improve patient outcomes and reduce costs, particularly for patients with chronic conditions. But studies of prevalence or impact at the population level are rare.
  
  
  OBJECTIVE
  We aimed to assess whether desired outcomes indicating better care delivery and patient-centeredness were associated with receipt of care according to 3 important PCMH principles.
  
  
  METHODS
  We analyzed data from a representative population survey in California in 2009, focusing on a population with chronic condition who had a usual source of care. We used bivariate, logistic, and negative-binomial regressions.
  
  
  METHODS
  The indicators of PCMH concordant care included continuity of care (personal doctor), care coordination, and care management (individual treatment plan). Outcomes included flu shots, count of outpatient visits, any emergency department visit, timely provider communication, and confidence in self-care.
  
  
  RESULTS
  We found that patients whose care was concordant with all 3 PCMH principles were more likely to receive flu shots, more outpatient care, and timely response from providers. Concordance with 2 principles led to some desired outcomes. Concordance with only 1 principle was not associated with desired outcomes.
  
  
  CONCLUSIONS
  Patients who received care that met 3 key aspects of PCMH: coordination, continuity, and management, had better quality of care and more efficient use of the health care system.
authors.affiliation: *UCLA Center for Health Policy Research, Los Angeles †Department of Health Policy and Management, UCLA Fielding School of Public Health ‡Department of Health Sciences, California State University, Fullerton, Los Angeles, CA.
authors.forename: Nadereh
authors.initials: N
authors.lastname: Pourat
authors.forename: Shana A
authors.initials: SA
authors.lastname: Charles
authors.forename: Sophie
authors.initials: S
authors.lastname: Snyder
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002140:California; D002908:Chronic Disease / Q000628:therapy*; D003142:Communication; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration*; D012648:Self Care; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult