ArticleJournal of general internal medicine2015
Categories of Practice Transformation in a Statewide Medical Home Pilot and their Association with Medical Home Recognition.
Article in Journal of general internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- The Association between Health Professional Shortage Area (HPSA) Status, Work Environment, and Nurse Practitioner Burnout and Job Dissatisfaction.Journal of health care for the poor and underserved · 2022Article
- Shifting Implementation Science Theory to Empower Primary Care Practices.Annals of family medicine · 2019Article
- Cost of Transformation among Primary Care Practices Participating in a Medical Home Pilot.Journal of general internal medicine · 2016Article
- Linking Structural Capabilities and Workplace Climate in Community Health Centers.Inquiry : a journal of medical care organization, provision and financingArticle
- Burnout, job satisfaction, and turnover intention among primary care nurse practitioners with their own patient panels.Nursing outlookArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundHealthcare purchasers have created financial incentives for primary care practices to achieve medical home recognition. Little is known about how changes in practice structure vary across practices or relate to medical home recognition.
objectiveWe aimed to characterize patterns of structural change among primary care practices participating in a statewide medical home pilot.
designWe surveyed practices at baseline and year 3 of the pilot, measured associations between changes in structural capabilities and National Committee for Quality Assurance (NCQA) medical home recognition levels, and used latent class analysis to identify distinct classes of structural transformation.
participantsEighty-one practices that completed surveys at baseline and year 3 participated in the study. MAIN MEASURES: Study measures included overall structural capability score (mean of 69 capabilities); eight structural subscale scores; and NCQA recognition levels.
resultsPractices achieving higher year-3 NCQA recognition levels had higher overall structural capability scores at baseline (Level 1: 28.4 % of surveyed capabilities, Level 2: 40.9 %, Level 3: 48.7 %; p value = 0.001). We found no association between NCQA recognition level and change in structural capability scores (Level 1: 33.2 % increase, Level 2: 30.8 %, Level 3: 33.7 %; p value = 0.88). There were four classes of practice transformation: 27 % of practices underwent "minimal" transformation (changing little on any scale); 20 % underwent "provider-facing" transformation (adopting electronic health records, patient registries, and care reminders); 26 % underwent "patient-facing" transformation (adopting shared systems for communicating with patients, care managers, referral to community resources, and after-hours care); and 26 % underwent "broad" transformation (highest or second-highest levels of transformation on each subscale). CONCLUSIONS AND RELEVANCE: In a large, state-based medical home pilot, multiple types of practice transformation could be distinguished, and higher levels of medical home recognition were associated with practices' capabilities at baseline, rather than transformation over time. By identifying and explicitly incentivizing the most effective types of transformation, program designers may improve the effectiveness of medical home interventions.
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