| Ambulatory office organization for internal medicine resident medical education. | |
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MedLine Citation:
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PMID: 20978423 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Residents will most effectively learn about ambulatory, systems-based practice by working in highly functional ambulatory practices; however, systems experiences in ambulatory training are thought to be highly variable. The authors sought to determine the prevalence of functional-practice characteristics at clinics where residents learn. METHOD: In 2007, the authors conducted a national survey of medical directors of resident continuity clinics using a comprehensive, Web-based instrument that included both a residency clinic assessment and a practice system assessment (PSA). The authors designed the PSA to estimate the Physician Practice Connections (PPC) score, indicating the readiness of a practice to function as a patient-centered medical home (PCMH). RESULTS: Of 356 clinic directors or physician representatives responding to an initial inquiry, 221 completed the survey (62%)--representing 185 programs (49% of accredited programs). The majority of clinics were hospital based (139/220; 63%) or hospital supported (41/220; 19%) and were located in urban settings (151/217; 70%). Estimated payer mix categories included Medicare or managed Medicare (169; 29%), Medicaid or managed Medicaid (161; 34%), and self-pay (156; 25%). The mean estimated PPC score was 53 points (of 100; SD = 17.6). Suburban and rural clinics, Veterans Affairs' clinics, federally qualified health centers, and clinics with a higher proportion of patients with commercial insurance or managed Medicare earned higher scores. CONCLUSIONS: A substantial portion of residency clinics have elements needed for PCMH recognition. However, clinics struggled with connecting these elements with coordination-of-care processes, suggesting areas for improvement to support better functioning of ambulatory training practices. |
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Authors:
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Stewart F Babbott; Brent W Beasley; Siddharta Reddy; F Daniel Duffy; Mohan Nadkarni; Eric S Holmboe |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Academic medicine : journal of the Association of American Medical Colleges Volume: 85 ISSN: 1938-808X ISO Abbreviation: Acad Med Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-25 Completed Date: 2011-01-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8904605 Medline TA: Acad Med Country: United States |
Other Details:
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Languages: eng Pagination: 1880-7 Citation Subset: AIM; IM |
Affiliation:
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Division of General and Geriatric Medicine, Department of Medicine, University of Kansas, Kansas City, Kansas 66160, USA. sbabbott@kumc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Ambulatory Care
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organization & administration* Humans Internal Medicine / education* Internship and Residency / standards* Specialization* United States |
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