Medical Homes and Quality

Medical Homes.  Patient Satisfaction Scores.  Quality.  All bullshit terms that are have been fabricated, abused, prostituted and co-opted.   And news studies show they may not even relate or effect each other.  One study in the journal Health Services Research asked 393 physician practices whether they implemented medical-home elements such as team-based care, electronic health records, disease registries, clinical decision support, quality measurement, patient reminders, email access and group visits. Then they surveyed 1,304 patients who received care at those clinics about their experience during the last six months. What did they find, you ask?  Amazingly enough, there was no association between a clinic’s use of patient-centered medical home processes and patients’ satisfaction with care.  Hmmmm.  That is weird?  In fact, the lack of improvement in patient experience remained even after controlling for characteristics of the clinics and patients that might have affected the results.  Crazy, right? Even better, in a recent Health Affairs study of 40 Los Angeles-area community health centers, it was found that those that had implemented more medical-home processes did not fare better on quality metrics in caring for patients with diabetes.   That shouldn’t matter because better quality metrics may not help the overall care of the patient anyway.  So what did we learn here?  Absolutely nothing other than these studies will be ignored by the government, our physician representatives and organizations, insurance companies and hospitals.    Why?  Because they have all bought into this unproven crap for different self-serving reasons.  And healthcare will suffer.

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