A First Look at PCMH Implementation for Minority Veterans

Room for Improvement

Bibliographic Data

ID9104018
AuthorsSusan E Hernandez, Susana Martín Hernández (0000-0002-7271-6281, AcademyHealth), Leslie Taylor (0000-0002-7301-4687, AcademyHealth), David Grembowski (0000-0003-4209-0019, AcademyHealth), Robert J Reid (0000-0002-9008-6375, AcademyHealth), Edwin S Wong (0000-0002-6079-686X, AcademyHealth), Edwin Wong, Karin M Nelson (0000-0003-4901-6751, AcademyHealth), Chuan-Fen Liu, Chuan‐Fen Liu (0000-0002-6915-8194, AcademyHealth), Stephan D Fihn (AcademyHealth), Paul L Hebert (0000-0002-5886-7964, AcademyHealth)
Year2016
Volume54
Issue3
Pages253-261
Publication date2016-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000512
PMID26871643
OpenAlexW2463574641
LanguageEN
Citations received3
References cited32

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. RESEARCH DESIGN: 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 ( 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

Environmental health · Ethnic group · Family medicine · Health care · Pact · Political science · Population · Veterans Affairs · Chronic Disease Management Strategies · Diabetes Management and Education · Medicine · Primary Care and Health Outcomes · Gerontology

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