New brief and white paper suggest ways to improve patient-centered medical home evidence and evaluations
Research Activities, February 2012, No. 378
Primary care clinicians, health care systems, insurers, State governments, families, and communities are turning to the primary care patient-centered medical home (PCMH) as a solution to many of the troubles of the fragmented U.S. health care system. The PCMH model is a way of organizing and delivering primary health care that is patient- and family-centered, comprehensive, coordinated, accessible, and structured to continuously improve quality and safety. AHRQ has released a white paper describing the sample and sample size that studies of the medical home need to detect true effects.
The paper discusses how to improve the quality of evaluations of the PCMH to ensure that the best policy decisions are made. Suggestions are provided to improve the quality of the evidence, by raising awareness about the need to account for clustering of patients within practices—an issue inherent in medical home research—and offering practical suggestions for designing studies.
The paper provides information about how to determine the effect sizes a given study can expect to detect, identifies the number of patients and practices required to detect policy-relevant, achievable effects, and demonstrates how evaluators can select the outcomes and types of patients included in analyses to improve a study's ability to detect true effects.
You can access the paper, Building the Evidence Base for the Medical Home: What Sample and Sample Size Do Studies Need? at http://pcmh.ahrq.gov/portal/server.pt/community/pcmh__home/1483. Please feel free to share this paper with colleagues who may be interested.
Additional resources can also be found on the PCMH Web site at http://www.pcmh.ahrq.gov.