Document Detail


Context for understanding the National Demonstration Project and the patient-centered medical home.
MedLine Citation:
PMID:  20530391     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This article introduces a journal supplement evaluating the country's first national demonstration of the patient-centered medical home (PCMH) concept. The PCMH is touted by some as a linchpin for renewing the foundering US health care system and its primary care foundation. The National Demonstration Project (NDP) tested a new model of care and compared facilitated and self-directed implementation approaches in a group-randomized clinical trial. The NDP asked what a national sample of 36 highly motivated family practices could accomplish in moving toward the PCMH ideal during 2 years within the current US health care payment and organizational system. Our independent evaluation used a multimethod approach that integrated qualitative methods to tell the NDP story from multiple perspectives and quantitative methods to assess and compare aspects that could be measured. The 7 scientific reports presented in this supplement explain the process, outcomes, lessons, and implications of the NDP. This introductory article provides context for making sense of the NDP. Important context includes the evolution of the PCMH concept and movement, the roots of the NDP and how it developed, and both what is valuable and what is problematic about family medicine and primary care. Together, the articles in this supplement show how primary care practices and the concept of the PCMH can continue to evolve. The evaluation depicts some of the early effects of this evolution on patients and practices, and shows how the process of practice development can be understood and how lessons from the NDP can inform ongoing and future efforts to transform primary care and health care systems.
Authors:
Kurt C Stange; William L Miller; Paul A Nutting; Benjamin F Crabtree; Elizabeth E Stewart; Carlos Roberto Jaén
Publication Detail:
Type:  Introductory Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of family medicine     Volume:  8 Suppl 1     ISSN:  1544-1717     ISO Abbreviation:  Ann Fam Med     Publication Date:  2010  
Date Detail:
Created Date:  2010-06-09     Completed Date:  2010-10-07     Revised Date:  2011-02-10    
Medline Journal Info:
Nlm Unique ID:  101167762     Medline TA:  Ann Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S2-8; S92     Citation Subset:  IM    
Affiliation:
Department of Family Medicine, and The Case Comprehensive Cancer Center, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA. kcs@case.edu
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MeSH Terms
Descriptor/Qualifier:
Humans
Models, Organizational
Multicenter Studies as Topic
Patient-Centered Care / methods,  organization & administration*,  standards
Primary Health Care / methods,  organization & administration*,  standards
Qualitative Research
Quality Assurance, Health Care / methods,  organization & administration,  standards
Randomized Controlled Trials as Topic
Grant Support
ID/Acronym/Agency:
K05 CA140237-01/CA/NCI NIH HHS
Comments/Corrections
Erratum In:
Ann Fam Med. 2010 Jul-Aug;8(4):369

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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