Transforming Primary Care in the New Orleans Safety-Net: The Patient Experience

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The Issue

There is a growing body of evidence showing that patient-centered medical homes (PCMHs) can lower the costs of delivering primary care while improving health outcomes. Yet little is known about how this model, which stresses continuity in the patient–provider relationship, multidisciplinary care teams, and coordination of patient services, affects patients’ own experiences. In this Commonwealth Fund–supported study, researchers examine ratings of health care accessibility, care coordination, and confidence in the quality and safety of care as reported by patients served by New Orleans safety-net clinics—a majority of which have achieved PCMH recognition from the National Committee for Quality Assurance, an accrediting organization.


What the Study Found

Across the sample of 1,573 patients, 63 percent gave positive ratings to their clinic on access to care as well as care quality and safety. But when asked how well their care was coordinated, only 33 percent reported a positive experience. Clinics with high PCMH scores were more likely to receive positive ratings on care coordination. Those with high PCMH scores, however, were not more likely to receive high patient ratings on access to care or confidence in care quality and safety.


Conclusions

The findings suggest that the medical home model is positively associated with patients’ experience of care coordination, a particularly important finding for chronically ill safety-net patients with multiple, complex needs. The study’s mixed results, however, show that more work is needed to understand how medical homes can improve other aspects of patient experience.

Publication Details

Publication Date:
February 8, 2013
Authors:
Laura A. Schmidt, Ph.D., M.S.W., M.P.H., Diane R. Rittenhouse, M.D., M.P.H., Kevin J. Wu, M.P.H., and James A. Wiley, Ph.D.
Summary Writer:
Martha Hostetter
Citation:

L. A. Schmidt, D. R. Rittenhouse, K. J. Wu et al., "Transforming Primary Care in the New Orleans Safety-Net: The Patient Experience," Medical Care, Feb. 2013 51(2):158–64.

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