How Is Family Medicine Engaging Patients at the Practice-Level?: A National Sample of Family Physicians

Journal of the American Board of Family Medicine: JABFM

Margae Knox^1¹  Anjana E. Sharma^1² 

[1]The American Board of Family Medicine, Lexington, KY (LEP)^1

[2]From Department of Family and Community Medicine, Center for Excellence in Primary Care, University of California, San Francisco, CA (AES, MK, RW-G, KG, MBP)

关键词: Family Physicians;    Logistic Regression;    Patient-Centered Care;    Patient Engagement;    Quality Improvement;    Surveys and Questionnaires;   

DOI  :  10.3122/jabfm.2018.05.170418

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

Introduction: Emerging policy consensus advocates that patient-centered care should include an active, practice-level patient role, but it is unknown how commonly these roles are implemented. We sought to understand current prevalence and predictors of practice-level patient engagement in US primary care settings. Methods: We assessed practice-level patient engagement by using 2016 American Board of Family Medicine Certification Examination registration data, restricted to ambulatory primary care site respondents randomly selected for a patient-centered medical home (PCMH) question module. Multivariate logistic regression models identified predictors of high-intensity patient engagement, defined as a patient advisory council or patient volunteers in quality improvement activities. Results: A total of 6900 examinees reported practicing in primary care sites; 1368 randomly received PCMH questions. Practice-level patient engagement included patient surveys (76.5%; 95% CI, 74.3–78.8%), patient suggestion boxes (52.9%; 95% CI, 50.2–55.5%), patient board of director memberships (18.8%; 95% CI, 16.7–20.9%), patient advisory councils (23.8%; 95% CI, 21.5–26.0%), and patient participation in quality improvement (20.5%; 95% CI, 18.3–22.6%). High-intensity patient engagement was reported by 31.1% (95% CI, 28.7–33.6%); predictors included large practice size (OR, 3.30; 95% CI, 1.96–5.57), serving more vulnerable patient populations, (OR, 1.83; 95% CI, 1.18–2.84) and PCMH certification (OR, 2.19; 95% CI, 1.62–2.97). Conclusions: Nearly one-third of physicians reported working in settings with high-intensity practice-level patient engagement. An implementation science approach should examine why high-intensity activities are more common in some practice settings and whether these activities add value through improved patient experience and health outcomes.

【 授权许可】

CC BY