title: Patient-Centered Medical Home Implementation and Burnout Among VA Primary Care Employees.
abstract: Burnout is widespread throughout primary care and is associated with negative consequences for providers and patients. The relationship between the patient-centered medical home model and burnout remains unclear. Using survey data from 8135 and 7510 VA primary care employees in 2012 and 2013, respectively, we assessed whether clinic-level medical home implementation was independently associated with burnout prevalence and estimated whether burnout changed among this workforce from 2012 to 2013. Adjusting for differences in respondent and clinic characteristics, we found that burnout was common among primary care employees, increased by 3.9% from 2012 to 2013, and was not associated with the extent of medical home implementation.
authors.affiliation: VA Puget Sound Healthcare System, Health Services Research and Development, Seattle-Denver COIN, Seattle, Washington (Drs Simonetti, Nelson, Taylor, Fihn, and Helfrich, and Mr Sylling); VA Puget Sound Healthcare System, General Internal Medicine Service, Seattle, Washington (Drs Nelson and Fihn); Division of General Internal Medicine, University of Washington, Seattle, Washington (Drs Simonetti, Nelson, and Fihn); Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts (Dr Mohr); Office of Analytics and Business Intelligence, Veterans Health Administration, Washington, District of Columbia (Ms Curtis and Dr Fihn); Office of Patient Care Services, US Department of Veterans Affairs, Washington, District of Columbia (Dr Schectman); Department of Health Services, University of Washington School of Public Health, Seattle, Washington (Drs Helfrich and Fihn); and Boston University School of Public Health, Boston, Massachusetts (Dr Mohr).
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Simonetti
authors.forename: Philip W
authors.initials: PW
authors.lastname: Sylling
authors.forename: Karin
authors.initials: K
authors.lastname: Nelson
authors.forename: Leslie
authors.initials: L
authors.lastname: Taylor
authors.forename: David C
authors.initials: DC
authors.lastname: Mohr
authors.forename: Idamay
authors.initials: I
authors.lastname: Curtis
authors.forename: Gordon
authors.initials: G
authors.lastname: Schectman
authors.forename: Stephan D
authors.initials: SD
authors.lastname: Fihn
authors.forename: Christian D
authors.initials: CD
authors.lastname: Helfrich
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration; D001291:Attitude of Health Personnel; D002055:Burnout, Professional; D003430:Cross-Sectional Studies; D006282:Health Personnel / Q000523:psychology*; D006284:Health Plan Implementation / Q000458:organization & administration* / Q000592:standards; D006787:Hospitals, Veterans / Q000458:organization & administration; D006801:Humans; D017146:Models, Organizational; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000639:trends; D014481:United States; D058014:Veterans Health / Q000639:trends; D000078329:Workforce