Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government
Veterans Benefits and Health Care About VA Find a VA Location

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Components of the Patient-Centered Medical Home Associated with Perceived Access to Primary Care.

Schuttner L, Gunnink E, Sylling P, Taylor L, Fihn SD, Nelson K. Components of the Patient-Centered Medical Home Associated with Perceived Access to Primary Care. Journal of general internal medicine. 2020 Jun 1; 35(6):1736-1742.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions


Abstract:

BACKGROUND: Following implementation of the patient-centered medical home (PCMH) within the Department of Veterans Affairs (VA), access to primary care improved. However, understanding of how this occurred is lacking. OBJECTIVE: To examine the association between organizational aspects of the PCMH model and access-related initiatives with patient perception of access to urgent, same-day, and routine care within the VA. DESIGN: Cross-sectional PARTICIPANTS: Veterans who responded to the annual Survey of Healthcare Experiences of Patients in 2016 (N? = 241,122 patients) and primary staff who responded to VA National Primary Care Provider and Staff Survey (N? = 4815 staff). MAIN MEASURES: Three outcomes of perception of access: percentage of patients responding in the highest category for same-day care (waiting = 1 day), urgent care (always receiving care when needed), and routine care (always receiving checkups when desired). Predictors were staff-level report of access-related initiatives and organizational factors in the clinic. We used generalized estimating equations to model associations, adjusting for characteristics of patients and their respective clinics. KEY RESULTS: Access was significantly better in clinics where staff reviewed performance reports (+?0.9% in the highest perception of access for urgent care, P? < 0.01; +?1.2% for routine care, P? < 0.001), leadership was supportive of the PCMH (+?1.6% for urgent care, P? < 0.01), and initiatives to improve access included open access (+?0.8% to +?1.7% across all outcomes, P? < 0.01) and telehealth visits (+?1.2% to +?1.4%, P? < 0.001). Perceived access was worse in clinics with moderate staff burnout (-?1.1% to -?1.4%, P? < 0.001), primary care provider turnover during the past year (-?1.0% to -?1.6%, P? < 0.001), or medical support assistant turnover in the past year (-?0.9% to -?1.4%, P? < 0.001). CONCLUSIONS: Perception of access was strongly associated with identifiable organizational factors and access-related initiatives within VA primary care clinics that could be adopted by other health systems.




Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.