Association of Principles of PCMH With Percentage of Preventive Services Received
| Receipt of Preventive Services | ||
|---|---|---|
| Principles of PCMH | βa (95% CI) | P Value |
| PCMH = patient-centered medical home; Ref = reference. | ||
| a Adjusted for patient age, sex, race/ethnicity, education level, insurance status, and self-rated health while accounting for correlation between patients within practices. Each β is from a separate model. | ||
| b Analyzed as continuous variable. | ||
| c Use of e-mail with patients was not included in multivariate models because of unstable estimates (only 3 practices used e-mail). | ||
| Global PCMH score | 2.3 (1.4 to 3.2) | <.001 |
| High-touch principles | 3.4 (2.2 to 4.5) | <.001 |
| Personal physician | 3.7 (1.7 to 5.8) | <.001 |
| Months patient enrolled in practice | 0.03 (−0.01 to 0.07)b | .13b |
| Number of visits in previous 2 years | 0.9 (0.6 to 1.3)b | <.001b |
| <5 | Ref | |
| 5–8 | 9.6 (4.6 to 14.7) | <.001 |
| 9–12 | 12.4 (7.6 to 17.2) | <.001 |
| ≥13 | 15.3 (10.6 to 20.1) | <.001 |
| Patient sees same doctor when getting care at practice | 4.4 (1.6 to 7.1) | .002 |
| Patient contacts primary care practice first when ill | 0.5 (−1.3 to 2.3) | .56 |
| Physician-directed team | 1.8 (−1.8 to 5.4) | .32 |
| Practice has nurse practitioners or physician assistants | 0.5 (−5.4 to 6.5) | .86 |
| Practice uses nurses/health educators for preventive counseling | 3.1 (−2.6 to 8.7) | .29 |
| Practice leadership seeks nursing input for making changes | 1.0 (−1.2 to 3.4) | .37 |
| Whole-person orientation | 5.6 (4.2 to 7.1) | <.001 |
| Well-visit in last 5 years | 12.3 (7.6 to 17.1) | <.001 |
| Treated at practice for acute illness | 0.7 (−3.9 to 5.3) | .78 |
| Number of chronic diseases | 2.8 (1.8 to 3.8)b | <.001b |
| ≤3 | Ref | |
| ≥4 | 5.8 (2.8 to 8.8) | <.001 |
| Coordination of care | 1.4 (−0.7 to 3.5) | .20 |
| Reports from tests/consultations available during patient visits | 0.4 (−4.2 to 4.9) | .87 |
| Results of tests communicated to patients | 2.5 (−0.5 to 5.6) | .10 |
| Referral system to link patients to community programs | 8.0 (3.8 to 12.3) | <.001 |
| Clinicians make hospital or nursing home visits | 0.9 (−4.4 to 6.2) | .74 |
| High-tech principles | 0.3 (−1.1 to 1.7) | .64 |
| Quality and safety | 0.8 (−1.2 to 2.8) | .45 |
| Use of electronic medical records | −2.1 (−7.8 to 3.7) | .48 |
| Use of information technology | 1.1 (−4.3 to 6.6) | .68 |
| Use of clinical decision support tools | 5.0 (0.3 to 9.7) | .04 |
| Performs continuous quality improvement | 1.6 (−3.4 to 6.6) | .52 |
| Enhanced accessc | −0.3 (−2.3 to 1.7) | .74 |
| Waiting time for appointment | −0.2 (−1.4 to 1.0) | .76 |
| Getting through the office by telephone | −0.4 (−1.9 to 0.9) | .52 |
| Use of Web site for marketing | −0.3 (−5.8 to 5.2) | .91 |