Table 2.
Change in Patient Experience of Chronic Illness Care by Improvement in Provider/Staff Ratings of Medical Home Capability
| Modified PACICa Domain (N = 574) | Unadjusted Mean Score | ∆ Mean Score (95% CI) | ||||||
|---|---|---|---|---|---|---|---|---|
| Low PCMH‐Improvement Group (<Median ∆)b | High PCMH‐Improvement Group (≥Median ∆)b | Estimated Difference‐in‐Differences in PACIC Scorec | ||||||
| Baseline | Postintervention | Baseline | Postintervention | Unadjusted Estimate | p‐value | Adjusted Estimated | p‐value | |
| Overall PACIC (n = 485) | 59.4 | 58.9 | 54.6 | 60.6 | 6.5 (−1.8, 14.8) | .13 | 7.7 (−1.1, 16.5) | .09 |
| Patient activation (n = 517) | 70.4 | 67.2 | 67.0 | 72.0 | 7.3 (−2.2, 16.9) | .13 | 8.9 (−1.2, 19.0) | .08 |
| Delivery system design (n = 517) | 83.1 | 77.4 | 78.1 | 77.4 | 4.5 (−3.6, 12.6) | .28 | 7.6 (−0.7, 16.0) | .07 |
| Goal setting/tailoring (n = 508) | 47.2 | 48.6 | 44.0 | 51.5 | 6.2 (−5.1, 17.4) | .28 | 4.4 (−7.3, 16.0) | .46 |
| Contextual care (n = 512) | 65.5 | 67.2 | 59.6 | 66.5 | 5.2 (−5.8, 16.2) | .35 | 6.1 (−5.6, 17.7) | .31 |
| Follow‐up/coordination (n = 494) | 32.9 | 36.7 | 32.0 | 40.6 | 4.9 (−6.5, 16.4) | .40 | 3.7 (−8.3, 15.7) | .55 |
The Patient Assessment of Chronic Illness Care (PACIC) was developed by Glasgow and colleagues to evaluate whether patients with illness experience care that aligns with models of chronic‐care delivery (Glasgow et al. 2005). This version was modified for use in the Safety Net Medical Home Initiative.
The Patient‐Centered Medical Home Score (100‐point scale: 0 = worst, 100 = best) was developed based on the 2008 National Committee for Quality Assurance PCMH standards, using five PCMH sub‐scales: access to care and communication with patients, communication with other providers, tracking data, care management, and quality improvement (Sugarman et al. 2014).
Estimates were obtained from generalized estimating equation (GEE) methods.
Adjusted for age group, self‐reported health status, and insurance status.