Faculty Articles


Supporting Medical Home Transformation Through Evaluation of Patient Experience in a Large Culturally Diverse Primary Care Safety Net.



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Journal of public health management and practice





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Lippincott Williams & Wilkins

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CONTEXT: The prevalence of chronic disease in the United States is rapidly increasing, with a disproportionate number of underserved, vulnerable patients sharing the burden. The Patient-Centered Medical Home (PCMH) is a care delivery model that has shown promise to improve primary care and address the burden of chronic illness.

OBJECTIVE: The purpose of this study was to (1) understand patient characteristics that might influence perceived patient experience in a large primary care safety net undergoing PCMH transformation; (2) identify community-level quality improvement opportunities to support ongoing transformation activities; and (3) establish a baseline of patient experience across the primary care safety net that could be used in repeated evaluations over the course of transformation.

DESIGN: A cross-sectional study design was used to conduct this research.

SETTING AND PARTICIPANTS: A total of 351 racially and ethnically diverse patients of 4 primary care safety net organizations in Broward County, Florida, were surveyed regarding their experience with access to care and coordination of care.

MAIN OUTCOME MEASURE: Reported access to care and coordination of care.

RESULTS: Patients with chronic disease who reported having visited the clinic 3 or more times in the past 12 months reported a better coordination of care experience than patients who had fewer than 3 visits in the past 12 months (odds ratio = 3.57; 95% confidence interval, 1.76-7.24). Patients without chronic disease who had been receiving care at the clinic for 2 or more years of care reported worse experience with access to care than patients with less than 2 years of care (odds ratio = 0.26; 95% confidence interval, 0.11-0.60.) Race, ethnicity, language, and education were not significant predictors of patient experience.

CONCLUSION: Findings support ongoing efforts to improve patient engagement among all patients and to enhance resources to manage chronic disease, including community-based self-management programs, in primary care safety nets undergoing PCMH transformation.


Medical Specialties | Medicine and Health Sciences | Osteopathic Medicine and Osteopathy


Adult, Aged, Ambulatory Care Facilities, Chronic Disease, Cross-Sectional Studies, Cultural Diversity, Female, Florida, Humans, Male, Middle Aged, Patient Satisfaction, Patient-Centered Care, Primary Health Care, Safety-net Providers, Socioeconomic Factors

Peer Reviewed

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