sábado, 2 de junio de 2012

Physician practices and readiness for medica... [Health Serv Res. 2012] - PubMed - NCBI

Health Serv Res. 2012 Feb;47(1 Pt 2):486-508. doi: 10.1111/j.1475-6773.2011.01332.x. Epub 2011 Oct 18.

Physician practices and readiness for medical home reforms: policy, pitfalls, and possibilities.

Hollingsworth JM, Saint S, Sakshaug JW, Hayward RA, Zhang L, Miller DC.

Source

Department of Urology, University of Michigan, Ann Arbor, MI 48109, USA.

Abstract

OBJECTIVE:

To determine the proportion of physician practices in the United States that currently meets medical home criteria.

DATA SOURCE/STUDY SETTING:

2007 and 2008 National Ambulatory Medical Care Survey.

STUDY DESIGN:

We mapped survey items to the National Committee on Quality Assurance's (NCQA's) medical home standards. After awarding points for each "passed" element, we calculated a practice's infrastructure score, dividing its cumulative total by the number of available points. We identified practices that would be recognized as a medical home (Level 1 [25-49 percent], Level 2 [50-74 percent], or Level 3 [infrastructure score ≥75 percent]) and examined characteristics associated with NCQA recognition.

RESULTS:

Forty-six percent (95 percent confidence interval [CI], 42.5-50.2) of all practices lack sufficient medical home infrastructure. While 72.3 percent (95 percent CI, 64.0-80.7 percent) of multi-specialty groups would achieve recognition, only 49.8 percent (95 percent CI, 45.2-54.5 percent) of solo/partnership practices meet NCQA standards. Although better prepared than specialists, 40 percent of primary care practices would not qualify as a medical home under present criteria.