Community health centers;
health disparities;
patient-centered medical home;
primary care;
DIABETES SELF-MANAGEMENT;
ADVANCED ACCESS;
HIGH-QUALITY;
PHYSICIANS;
MINORITY;
LESSONS;
D O I:
10.1353/hpu.2012.0099
中图分类号:
R19 [保健组织与事业(卫生事业管理)];
学科分类号:
摘要:
Health care disparities pose an ongoing challenge to the nation. The patient-centered medical home (PCMH) model presents a unique opportunity for community health centers (CHCs) to improve the health of medically underserved communities and reduce health care disparities. Community health centers face ongoing financial and operational challenges, but are well positioned to adopt the PCMH. Health centers have experience collaborating on quality improvement initiatives and possess a strong organizational structure. The culture of CHCs emphasizes cultural competence, team work, and patient-centrism, and is well-aligned with the PCMH model. However, CHCs need more support to make fundamental changes in processes and practice culture. Many of these changes require substantial redesigns that can challenge even the most innovative practices. State and federal policy should focus on providing training, guidance, and payment mechanisms that support PCMH. Taking these steps, the U.S. can achieve the goal that every American receives patient-centered care that is equitable, affordable, and effective.
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA
Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Los Angeles, CA USAUniv Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA
Asarnow, Joan Rosenbaum
Kolko, David J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Special Serv, Western Psychiat Inst & Clin, Pittsburgh, PA 15260 USA
Univ Pittsburgh, Sch Med, Psychiat Psychol Pediat & Clin & Translat Sci, Pittsburgh, PA 15260 USAUniv Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA
Kolko, David J.
Miranda, Jeanne
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA
Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Los Angeles, CA USAUniv Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA
Miranda, Jeanne
Kazak, Anne E.
论文数: 0引用数: 0
h-index: 0
机构:
Nemours Childrens Hlth Syst, Ctr Healthcare Delivery Sci, Wilmington, DE USA
Thomas Jefferson Univ, Sidney Kimmel Med Sch, Dept Pediat, Philadelphia, PA 19107 USAUniv Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA
机构:
Univ Michigan, Dept Urol, Dow Div Hlth Serv Res, Ann Arbor, MI 48105 USA
Univ Michigan, Robert Wood Johnson Fdn, Clin Scholars Program, Ann Arbor, MI 48105 USAUniv Michigan, Dept Urol, Dow Div Hlth Serv Res, Ann Arbor, MI 48105 USA
Hollingsworth, John M.
Saint, Sanjay
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan, Robert Wood Johnson Fdn, Clin Scholars Program, Ann Arbor, MI 48105 USA
VA Ann Arbor Hlth Serv Res & Dev Ctr Excellence, Ann Arbor, MI USA
Univ Michigan, Patient Safety Enhancement Program, VA Ann Arbor Med Ctr, Ann Arbor, MI 48105 USA
Univ Michigan, Dept Internal Med, Div Gen Med, Ann Arbor, MI 48105 USAUniv Michigan, Dept Urol, Dow Div Hlth Serv Res, Ann Arbor, MI 48105 USA
Saint, Sanjay
Hayward, Rodney A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan, Robert Wood Johnson Fdn, Clin Scholars Program, Ann Arbor, MI 48105 USA
VA Ann Arbor Hlth Serv Res & Dev Ctr Excellence, Ann Arbor, MI USA
Univ Michigan, Dept Internal Med, Div Gen Med, Ann Arbor, MI 48105 USAUniv Michigan, Dept Urol, Dow Div Hlth Serv Res, Ann Arbor, MI 48105 USA
Hayward, Rodney A.
Rogers, Mary A. M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan, Robert Wood Johnson Fdn, Clin Scholars Program, Ann Arbor, MI 48105 USA
VA Ann Arbor Hlth Serv Res & Dev Ctr Excellence, Ann Arbor, MI USA
Univ Michigan, Dept Internal Med, Div Gen Med, Ann Arbor, MI 48105 USAUniv Michigan, Dept Urol, Dow Div Hlth Serv Res, Ann Arbor, MI 48105 USA
Rogers, Mary A. M.
Zhang, Lingling
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan, Ctr Stat Consulting & Res, Ann Arbor, MI 48105 USAUniv Michigan, Dept Urol, Dow Div Hlth Serv Res, Ann Arbor, MI 48105 USA
Zhang, Lingling
Miller, David C.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan, Dept Urol, Dow Div Hlth Serv Res, Ann Arbor, MI 48105 USA
VA Ann Arbor Hlth Serv Res & Dev Ctr Excellence, Ann Arbor, MI USA
Univ Michigan, Ctr Healthcare Outcomes & Policy, Ann Arbor, MI 48105 USAUniv Michigan, Dept Urol, Dow Div Hlth Serv Res, Ann Arbor, MI 48105 USA
机构:
Philadelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA 19104 USA
Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15260 USAPhiladelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA 19104 USA
Tew, James
Klaus, Johanna
论文数: 0引用数: 0
h-index: 0
机构:
Philadelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA 19104 USA
Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15260 USAPhiladelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA 19104 USA
Klaus, Johanna
Oslin, David W.
论文数: 0引用数: 0
h-index: 0
机构:
Philadelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA 19104 USA
Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15260 USAPhiladelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA 19104 USA
机构:
VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USAVA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA
Jones, Audrey L.
Cochran, Susan D.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Epidemiol, Los Angeles, CA USA
Univ Calif Los Angeles, Dept Stat, Los Angeles, CA USA
Univ Calif Los Angeles, Ctr Bridging Res Innovat, Training & Educ Minor Hlth Dispar Solut, Los Angeles, CA USAVA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA
Cochran, Susan D.
Leibowitz, Arleen
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, Luskin Sch Publ Affairs, Los Angeles, CA USAVA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA
Leibowitz, Arleen
Wells, Kenneth B.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA
Univ Calif Los Angeles, Ctr Hlth Serv & Soc, Los Angeles, CA USA
Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Hlth Policy & Management, Los Angeles, CA USAVA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA
Wells, Kenneth B.
Kominski, Gerald
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Hlth Policy & Management, Los Angeles, CA USA
Univ Calif Los Angeles, Ctr Hlth Policy Res, Los Angeles, CA USAVA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA
Kominski, Gerald
Mays, Vickie M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, Ctr Bridging Res Innovat, Training & Educ Minor Hlth Dispar Solut, Los Angeles, CA USA
Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Hlth Policy & Management, Los Angeles, CA USA
Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USAVA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Ctr Educ Dev & Res, Los Angeles, CA 90095 USAUniv Calif Los Angeles, David Geffen Sch Med, Ctr Educ Dev & Res, Los Angeles, CA 90095 USA
Wilkerson, LuAnn
Fung, Cha-Chi
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Ctr Educ Dev & Res, Los Angeles, CA 90095 USA
Univ So Calif, Keck Sch Med, Off Educ Affairs, Los Angeles, CA 90033 USAUniv Calif Los Angeles, David Geffen Sch Med, Ctr Educ Dev & Res, Los Angeles, CA 90095 USA
Fung, Cha-Chi
May, Win
论文数: 0引用数: 0
h-index: 0
机构:
Univ So Calif, Keck Sch Med, Div Med Educ, Los Angeles, CA 90033 USAUniv Calif Los Angeles, David Geffen Sch Med, Ctr Educ Dev & Res, Los Angeles, CA 90095 USA
May, Win
Elliott, Donna
论文数: 0引用数: 0
h-index: 0
机构:
Univ So Calif, Keck Sch Med, Off Educ Affairs, Los Angeles, CA 90033 USAUniv Calif Los Angeles, David Geffen Sch Med, Ctr Educ Dev & Res, Los Angeles, CA 90095 USA
机构:
US Dept Hlth & Human Serv, Off Planning Anal & Evaluat Hlth Resources & Serv, Off Res & Evaluat, Rockville, MD 20857 USAUS Dept Hlth & Human Serv, Off Planning Anal & Evaluat Hlth Resources & Serv, Off Res & Evaluat, Rockville, MD 20857 USA
Lebrun-Harris, Lydie A.
Shi, Leiyu
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA
Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Primary Care Policy Ctr, Baltimore, MD USAUS Dept Hlth & Human Serv, Off Planning Anal & Evaluat Hlth Resources & Serv, Off Res & Evaluat, Rockville, MD 20857 USA
Shi, Leiyu
Zhu, Jinsheng
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA
Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Primary Care Policy Ctr, Baltimore, MD USAUS Dept Hlth & Human Serv, Off Planning Anal & Evaluat Hlth Resources & Serv, Off Res & Evaluat, Rockville, MD 20857 USA
Zhu, Jinsheng
Burke, Matthew T.
论文数: 0引用数: 0
h-index: 0
机构:
Franklin Sq Hosp, Dept Family Med, Baltimore, MD USAUS Dept Hlth & Human Serv, Off Planning Anal & Evaluat Hlth Resources & Serv, Off Res & Evaluat, Rockville, MD 20857 USA
Burke, Matthew T.
Sripipatana, Alek
论文数: 0引用数: 0
h-index: 0
机构:
US Dept Hlth & Human Serv, Off Qual & Data, Bur Primary Hlth Care Hlth Resources & Serv, Rockville, MD 20857 USAUS Dept Hlth & Human Serv, Off Planning Anal & Evaluat Hlth Resources & Serv, Off Res & Evaluat, Rockville, MD 20857 USA
Sripipatana, Alek
Ngo-Metzger, Quyen
论文数: 0引用数: 0
h-index: 0
机构:
US Dept Hlth & Human Serv, US Prevent Serv Task Force, Ctr Primary Care Prevent & Clin Partnerships, Agcy Healthcare Res & Qual, Rockville, MD 20857 USAUS Dept Hlth & Human Serv, Off Planning Anal & Evaluat Hlth Resources & Serv, Off Res & Evaluat, Rockville, MD 20857 USA
机构:
Univ Alabama, Dept Community Med & Populat Hlth, Tuscaloosa, AL USA
Univ Alabama, Inst Rural Hlth Res, Tuscaloosa, AL USAUniv Alabama, Dept Community Med & Populat Hlth, Tuscaloosa, AL USA
Gregg, Abbey
Kim, Jungyoon
论文数: 0引用数: 0
h-index: 0
机构:
Univ Nebraska Med Ctr, Dept Hlth Serv Res & Adm, Omaha, NE USAUniv Alabama, Dept Community Med & Populat Hlth, Tuscaloosa, AL USA
Kim, Jungyoon
Tak, Hyo Jung
论文数: 0引用数: 0
h-index: 0
机构:
Univ Nebraska Med Ctr, Dept Hlth Serv Res & Adm, Omaha, NE USAUniv Alabama, Dept Community Med & Populat Hlth, Tuscaloosa, AL USA
Tak, Hyo Jung
Wang, Hongmei
论文数: 0引用数: 0
h-index: 0
机构:
Univ Nebraska Med Ctr, Dept Hlth Serv Res & Adm, Omaha, NE USAUniv Alabama, Dept Community Med & Populat Hlth, Tuscaloosa, AL USA
Wang, Hongmei
Tibbits, Melissa
论文数: 0引用数: 0
h-index: 0
机构:
Univ Nebraska Med Ctr, Dept Hlth Promot, Omaha, NE USAUniv Alabama, Dept Community Med & Populat Hlth, Tuscaloosa, AL USA
Tibbits, Melissa
Webhi, Nizar
论文数: 0引用数: 0
h-index: 0
机构:
Univ Nebraska Med Ctr, Dept Hlth Serv Res & Adm, Omaha, NE USAUniv Alabama, Dept Community Med & Populat Hlth, Tuscaloosa, AL USA