PURPOSEThe patient medical home (PMH) model aims to improve patient satisfaction and health outcomes in Canada, but since its introduction in 2009, there has been no evaluation of the extent to which primary care conforms with PMH attributes. Our objective was to compare current primary care across Canada with the 10 goals of the PMH model. METHODSA cross-sectional survey of primary care organization and delivery was conducted in Canadian provinces to evaluate the PMH-based attributes of primary care practices. Family physician and patient responses were mapped to the 10 goals of the PMH model. We used regression models to describe the provinces' success in meeting the goals, taking specific practice characteristics into account. We created a PMH composite score by weighting each goal equally for each practice and aggregating these by province. The PMH score is the sum of the values for each goal, which were scored from 0 to 1; a score of 10 indicates that all 10 goals of the PMH model were achieved.RESULTS Seven hundred seventy-two primary care practices and 7,172 patients participated in the survey. The average national PMH score was 5.36 (range 4.75-6.23) of 10. Ontario was the only province to score significantly higher than Canada as a whole, whereas Québec, Newfoundland/Labrador, and New Brunswick/Prince Edward Island scored below the national average. There was little variation, however, among provinces in achieving the 10 PMH goals.CONCLUSIONS Provincial PMH scores indicate considerable room for improvement if the PMH goals are to be fully implemented in Canada. INTRODUCTIONE ffective primary care greatly improves overall population health while supporting general health systems performance.1,2 Strong primary care systems are associated with a more equitable distribution of health services and lower health care costs. 3 One of the mechanisms underlying the positive impact of primary care is the delivery model. 2 The patient-centered medical home (PCMH) is an approach to providing comprehensive primary care. 4 Its fundamental principles include patients forming a relationship with a personal physician, striving for whole-person orientation, ensuring care is coordinated and/or integrated, and a focus on quality, safety, and access. 4 In the United States, the PCMH is associated with lower health care costs and improved quality of and satisfaction with primary care. 5The College of Family Physicians Canada (CFPC) introduced the patient medical home (PMH), a made-in-Canada version of the PCMH, as a model for best practice in 2009. 6 The CFPC defines the PMH by 10 goals ( 231The de facto guidelines for evaluating primary care models in the United States are the National Committee for Quality Assurance's Patient-Centered Medical Home Standards, developed in collaboration with interested stakeholders and updated every 3 years. [9][10][11][12] In Canada, different primary care reform initiatives have been implemented in each province during the past decade, but there is no systematic evaluation tool t...
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