Consumer assessment of the Patient-Centered Medical Homes health care delivery model in Federally Qualified Health Center

Anna M Serrano, The University of Texas School of Public Health


A cross-sectional study was conducted, aimed at obtaining baseline information on how patients rate the performance of a Patient-Centered Medical Home (PCMH) recognized Community Health Center (CHC) in Texas, utilizing the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey tool which includes the Patient-Centered Medical Home items set, made available in the public domain by the U.S. Agency for the Healthcare Research and Quality (AHRQ). The AHRQ CAHPs database was used for comparative analysis to identify similarities or differences in CAHPS ratings between the study organization and aggregate national ratings stratified by region, Ethnicity and Health Center venue. The study CHC was found to be significantly dissimilar demographically than the CAHPS database overall and the South Region. The predominately female study respondents were younger, with lower educational attainment, Hispanic and reported poorer health than the national comparison groups. Derived predictors of positive CAHPS ratings among this group were: (1) Access to Care perception and (2) High Utilization. In terms of PCMH Domains, the study CHC scored significantly higher than the CAHPS Overall (national) group in terms of Comprehensiveness and Whole Person Orientation, as well as Self-Management, but lower in Coordination of Care. Shared Decision Making was similarly scored across all comparison groups as were provider ratings, highly-scored, speaking to the Primary Care Provider (PCP) connection and relationship-building requisite to establishing and/or fostering the medical home model of care. This study highlights that patient perception of Access to Care is the primary driver of satisfaction scores across the Patient Centered Medical Home Domains, inclusive of Comprehensiveness of Care, Self-Management, Coordination of Care and Communication, regardless of demographic characteristics or overall health status. Moreover, Access to Care is found to be one of the lowest scoring PCMH Domains across comparison groups suggestive of a broader primary care system issue.

Subject Area

Public health|Health care management

Recommended Citation

Serrano, Anna M, "Consumer assessment of the Patient-Centered Medical Homes health care delivery model in Federally Qualified Health Center" (2014). Texas Medical Center Dissertations (via ProQuest). AAI3665206.