A First Look at PCMH Implementation for Minority Veterans: Room for Improvement.
Med Care
; 54(3): 253-61, 2016 Mar.
Article
em En
| MEDLINE
| ID: mdl-26871643
ABSTRACT
BACKGROUND:
Implementation of Patient Aligned Care Teams (PACT), a patient-centered medical home model, has been inconsistent among the >900 primary care facilities in the Veterans Health Administration.OBJECTIVE:
Estimate if the degree of PACT implementation at a facility varied with the percentage of minority veteran patients at the facility. RESEARCHDESIGN:
Cross-sectional, facility-level analysis of PACT implementation measures in 2012.SUBJECTS:
Veterans Health Administration hospital-based and community-based primary care facilities.MEASURES:
We used a previously validated PACT Implementation Progress Index (Pi) and its 8 domains access, continuity of care, care coordination, comprehensiveness, self-management support, and patient-centered care and communication, shared decision-making domains, and team functioning. Facilities were categorized as low (<5.2%, n=208), medium (5.2%-25.8%, n=413), and high (>25.8%, n=206) percent minority based on the percent of their own veteran population.RESULTS:
Most minority veterans received care in high minority (69%) and medium minority facilities (29%). In adjusted analyses, medium and high minority facilities scored 0.773 (P=0.009) and 0.930 (P=0.008) points lower on the Pi score relative to low minority facilities. Relative to low minority facilities, both medium and high minority facilities were less likely of having high Pi scores (≥2) and more likely of having low Pi scores (≤-2). Both medium and high minority facilities had the same 3 domain scores lower than low minority facilities (care coordination, comprehensiveness, and self-management).CONCLUSION:
Overall PACT implementation varied with respect to the racial/ethnic composition of a facility, with medium and high minority facilities having a lower implementation scores.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Veteranos
/
United States Department of Veterans Affairs
/
Assistência Centrada no Paciente
/
Grupos Minoritários
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article