A Patient’s Medical Home ensures timely access to appointments within the practice, and advocates for and coordinates timely appointments with other health professionals.Better access to care can reduce duplication of services, improve health outcomes, achieve better patient and provider satisfaction, and lead to fewer emergency visits.
Supporting Research Articles
Wright PM. Reducing health disparities for women through use of the medical home model. Contemp Nurse. 2017;
The MHM provides an example of how healthcare can be provided in a more coordinated and effective manner. Extension of this model into the area of women's health may be one way to reduce barriers to quality, accessible care for women.
Ammi M, Ambrose S, Hogg B, Wong S. The influence of registered nurses and nurse practitioners on patient experience with primary care: results from the Canadian QUALICO-PC study. Health Policy. 2017;
Different types of nurses influence different dimensions of accessibility, and the association between patient experience and nurse staffing depends on the number of physicians in the clinic.
Strumpf E, Ammi M, Diop M, Fiset-Laniel J, Tousignant P. The impact of team-based primary care on health care services utilization and costs: Quebec's family medicine groups. J Health Econ. 2017;
Primary care organizational reforms can have impacts on the health care system in the absence of changes to physician payment mechanisms.
Dixon SK, Hoopes AJ, Benkeser D, Grigg A, Grow HM. Characterizing Key Components of a Medical Home Among Rural Adolescents. J Adolesc Health. 2016;
This sample of rural adolescents reported receiving many characteristics of a medical home but had limited experience with personal providers and confidential services. Improving adolescent access to confidential care may be especially important in small, rural communities. The association of a primary provider with improved medical home experience highlights this key characteristic in an adolescent medical home.
Yoon J, Chow A, Rubenstein LV. Impact of Medical Home Implementation Through Evidence-based Quality Improvement on Utilization and Costs. Med Care. 2016;
After PCMH implementation, overall utilization for primary care, specialty care, and mental health/substance abuse care decreased, whereas utilization for telephone care increased among all practices. Patients also had fewer hospitalizations and lower costs per patient.
Bois C, Michaud C, Pineault R, Guay M. [Retombées des ordonnances collectives dans le suivi diabétique conjoint en soins primaires : une étude de cas]. Santé publique. 2015;27(1 Suppl):S111-8.
This case study emphasises the benefits of team based care for diabetic patients. Patient's receiving well coordinated team based care are more likely to engage in self-care resulting in increased disease management. (Study in French)
Freeman, T., Brown, J., Reid, G., Stewart, M., Thind, A., & Vingilis, E. (2013). Patients’ perceptions on losing access to FPs: qualitative study. Canadian Family Physician, 59, 195-201.
Summary of Findings: This qualitative study interviews individuals on their health-related experiences after losing their personal family physician. A majority of participants reported distress, as they no longer had consistent access to preventative care. The quality of chronic illness management also decreased significantly.
Michael, M., Schaffer, S., Egan, P., Little, B., & Pritchard, P. (2013). Improving Wait Times and Patient Satisfaction in Primary Care. Journal for Healthcare Quality , 35, 50-60.
Summary of Findings: This study compares two frameworks designed to improve patient satisfaction by minimizing wait times. Both were able to reduce wait times by 10 minutes, leaving room for further research and quality improvement to build on these frameworks to increase quality of care.
Randall, E., Crooks, V., Goldsmith, L. (2012). In search of attachment: a qualitative study of chronically ill women transitioning between family physicians in rural Ontario, Canada. BMC Family Practice, 13, 125.
Summary of Findings: This qualitative study interviews women in rural Ontario, Canada with chronic illnesses on continuity of care and stresses the necessity of personal family physicians. There is a shortage in physicians practicing in rural areas, which causes patients to frequently transition through personal family physicians, limiting their continuity of patient-centred care and worsening their health outcomes.
Ferrante JM, Balasubramanian BA, Hudson SV, Crabtree BF. Principles of the patient-centered medical home and preventive services delivery. Ann Fam Med. 2010;8(2):108-116.
Summary of Findings: This study assessed clinics utilizing the principles of the Patient’s Medical Home, such as a personal family physician, were far more likely to receive preventative services.
Reid RJ, Fishman PA, Yu O, et al. Patient-centered medical home demonstration: a prospective, quasi-experimental, before and after evaluation. Am J Managed Care. 2009;15(9):e71-e87.
Summary of Findings: This study surveyed clinics practicing a patient-centred medical home system and found that patients achieve better outcomes at a lower cost compared to clinics not using the PCMH model.
Haggerty JL, Pineault R, Beaulieu M-D, et al. Practice Features Associated With Patient-Reported Accessibility, Continuity, and Coordination of Primary Health Care. Ann Fam Med. 2008;6(2):116-123.
Summary of Findings: This study compares the relationship between patient-centred care and the sustainability of the Canadian healthcare system. It emphasizes the increased demand for primary care as the population ages, and recommends a shift to patient-centred care in order to sustain the healthcare system and better health outcomes.
Clatney L, MacDonald H, Shah SM. Mental health care in the primary care setting: family physicians’ perspectives. Can Fam Physician. 2008;54(6):884-889.
Summary of Findings: This survey reveals that primary practicioners are unsatisfied with the quality of mental health care they are able to provide for their patients due to barriers in accessing mental health specialists urging the need for increased team-based care.
Murray M, Tantau C. Same-day appointments: exploding the access paradigm. Fam Pract Manage. 2000;7(8):45.
Summary of Findings: Three different primary care appointment booking models are compared. Clinics that have embraced the advanced same-day care model were able to reduce appointment wait times from 55 days to 1 day.