The utility of the medical home: a survey on patient perspectives
Background
Many articles exist outlining the possible benefits of the medical home model on enhanced patient care and reduced over-utilization of the medical system. So far, these articles have focused mainly on the viewpoint of physicians and their perceptions of what patients prefer, with relatively few addressing solely the patient perspectives. Some articles have addressed patient perspectives as a component of a larger study. This study attempts to put into words and data actual patient preferences for a medical home model. In addition, the study aimed to determine whether patients understand their health conditions, what they thought about having multiple doctors, whether they want their primary physician to complete an initial workup before referral to a specialist, and other issues important to patient satisfaction and perceptions of their care.
Methods
Fifty-six nonhospitalized English-speaking adults between 18 and 85 years of age and of any ethnic background were surveyed. They responded to a 10-question survey and were asked to rank items—their understanding of their medical problems; the explanation of their problems by their primary care physician (PCP) vs. their specialists; the importance of having their medical information in one place, of obtaining tests before being referred, of seeing a specialist when they had multiple medical conditions, of the PCP's role as a gatekeeper, and of understanding compliance; as well as the necessity of having their PCP clarify treatment plans developed by their specialist—from 1 to 5 based on preference. Results were tabulated and graphed. The study was reviewed by Nova Southeastern University College of Osteopathic Medicine Institutional Review Board.
Results
The majority of patients admitted to having good to very good understanding of their medical conditions. In their opinion, this understanding is attributable more so to their PCP than to their specialist. Fifty-three percent of patients stated that they need further clarification of plans developed by their specialist. Of the patients surveyed, 57% preferred one doctor, as opposed to 39% who preferred more than one doctor, and 4% who had no preference. In addition, patients also had a strong preference for having initial tests done before being sent to a specialist. However, they did want to be sent to specialists if needed. Patients acknowledged that compliance with treatment plans is linked to a thorough understanding of their medical problems.
Interpretation and conclusion
The data show that the medical home is of benefit to not only the patients, as evidenced by their preferences, but also to the physician because of better understanding of medical conditions leading to better compliance with treatment plans.
ABSTRACT