Aspects of the patient-centered medical home (PCMH) model won over a tough audience — those who get care from federally funded health centers — in a recent study in Annals of Family Medicine (AFM).

About 1,100 such centers serve more than 20 million people, 62% of whom are racial or ethnic minorities.

“These high patient ratings among health centers are especially remarkable given that low-income and uninsured patients across the United States generally rate their care much lower,” says the study, “Effects of Patient-Centered Medical Home Attributes on Patients’ Perceptions of Quality in Federally Supported Health Centers,” in the November/December issue of AFM.

The study says that 84% of about 4,500 patients surveyed think that PCMHs provide excellent or very good overall quality, while 81% say that clinician care at PCMHs is excellent or very good.

In contrast, the Commonwealth Fund’s 2010 Biennial Health Insurance Survey found that only 35% of low-income adults and 27% of uninsured adults report excellent or very good care.

Patient perception counts for a lot. “Measuring patients’ perspectives of quality is important because these subjective measures of satisfaction relate to objective measures of quality,” the study says.

“For instance, patients who view their care positively are more likely to cooperate with their clinicians, and follow recommendations, leading to better outcomes. Patient satisfaction is also associated with greater clinician adherence to clinical practice guidelines, better recovery from symptoms, improved emotional health, and fewer diagnostic tests and referrals.”

The respondents were asked to evaluate seven PCMH attributes:

  • Getting to the center
  • Getting care once they got there
  • Communicating with clinicians
  • Communicating with staff
  • Getting support to self-manage chronic conditions
  • Getting support to self-manage behavioral risks
  • Getting comprehensive preventive care

The data were gathered in face-to-face interviews conducted between September and December 2009.

The authors admit, though, that patient satisfaction might not always be an indication of how well a PCMH performs.

“Indeed, our study found that patients’ reports of certain PCMH attributes (i.e., self-management support for chronic diseases and behavioral risks, comprehensive preventive services) were generally not associated with patients’ ratings of quality.”

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