A REVIEW OF CURRENT QUALITY METRICS FOR EVALUATING PATIENT-CENTERED MEDICAL HOMES
Author(s)
Varga S1, Lombardi M2, Maio V1
1Thomas Jefferson University, Philadelphia, PA, USA, 2Parma Local Health Authority, Parma, Italy
OBJECTIVES: The patient-centered medical home (PCMH) has emerged as a promising model for transforming the structure and organization of primary care. The goal of PCMHs is to achieve improved patient care by delivering the triple aim of better quality, experience and cost. Rigorous evaluations of the ability of PCMHs to accomplish their objectives are needed to assess the feasibility of implementation. We sought to explore the quality metrics that are currently utilized to assess PCMHs. METHODS: An extensive literature review was performed using PubMed, SCOPUS and Google Scholar evaluating the published studies and reports that analyzed quality metrics used to assess PCMHs. Each measurement was analyzed and categorized into one of the following types of outcomes: access, utilization management, economic, clinical and humanistic. RESULTS: Overall, a significant number of quality metrics for assessing PCMHs was found. Access outcomes are composed of various aspects involving scheduling appointments, hours of operation, and provider remote access. Utilization management outcomes include use of healthcare services, including hospital, specialist, and nursing facility. Economic outcomes focus on spending of various healthcare services, such as inpatient, emergency department, pharmacy, and specialist costs. Humanistic outcomes incorporate patient and clinician satisfaction. Clinical outcomes are the most populated, including preventive services, such as immunization and screening, and management of several diseases, including diabetes, and cardiovascular and respiratory conditions. Quality metrics for diseases focus mainly on process of care, while a few define prominent outcomes of care, such as HbA1c and BMI level. CONCLUSIONS: This review identified an abundance of quality metrics utilized to assess PCMHs, yet only a few appear a true representation of the quality of care provided to patients. We urge entities and accreditation bodies involved in the establishment and implementation of PCMH to concur on and endorse a core set of standardized measures to evaluate the PCMH.
Conference/Value in Health Info
2016-05, ISPOR 2016, Washington DC, USA
Value in Health, Vol. 19, No. 3 (May 2016)
Code
PHS161
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Quality of Care Measurement
Disease
Multiple Diseases