Patient centered medical home helps assess social health determinants and promote health

April 25, 2013, Boston University Medical Center

Physicians from the Departments of Pediatrics and Family Medicine at Boston Medical Center (BMC) and Boston University School of Medicine (BUSM) are proposing that current pediatric guidelines and practices could be implemented within a Patient Centered Medical Home model to address social determinants of health. The article, published in the Journal of the American Medical Association (JAMA), also suggests that these guidelines could reduce socioeconomic disparities in health care for all patients.

Arvin Garg, MD, MPH, assistant professor of pediatrics at BUSM and pediatrician at BMC, served as the study's first author. Barry Zuckerman, MD, professor of pediatrics at BUSM and a pediatrician at BMC, and Brian Jack, MD, Chief and Chair of at BMC and BUSM, were the article's co-authors.

A Patient Centered Medical Home (PCMH) is a comprehensive and coordinated health care model in which a team of providers coordinate all of the patient's health needs, including management of , visits to specialists, hospital admissions and routine health screenings. Socioeconomic disparities continue to play a role in the health of children and families. Previous studies have shown that the environment in which a patient lives can impact their health, and these factors have historically been managed by public health and community organizations. However, a PCMH model allows for physicians to play a role in examining the of health in order to assess and treat patients with a more holistic approach and improve population health.

The authors list five recommendations to help address social context of patient care within the PCMH model: making social determinants of health an important aspect of clinical guidelines; screening for particular social determinants at medical visits; helping patients and families access community based resources, such as Women, Infants, and Children (WIC), job training and food pantries; implementing "outside the box" multidisciplinary primary care interventions, such as programs like Reach out and Read, the Medical-Legal Partnership and Health Leads (developed at BMC); and integrating home visiting programs to better understand living conditions.

They suggest that the implementation of these guidelines will provide important data about the types of services necessary to improve . Additionally, the indicators related to social determinants of care may some day become part of pay for performance and quality evaluation metrics of the medical home model.

"Overall, implementing social determinants of health within the PCMH model will potentially reduce socioeconomic disparities in health that continue to exist today and ultimately improve the health care system, especially for PCMH's that serve low-income patient populations," said the authors.

The authors note that the "medical home" is not a novel concept in the world of pediatrics. Current guidelines and practices within pediatrics now address social risks of populations and these guidelines are adaptable to adult and elderly populations within the as well.

Explore further: Use of patient centered medical home features not related to patients' experience of care

Related Stories

Use of patient centered medical home features not related to patients' experience of care

June 8, 2012
Providing patient care using key features of a Patient-Centered Medical Home (PCMH), a model of health care delivery promoted by major physician groups, may not influence what patients think about the care they receive, reports ...

Preventive law becomes preventive medicine

October 22, 2012
In a commentary to appear in the Oct. 22 issue of the journal Pediatrics, Barry Zuckerman, MD, the Joel and Barbara Alpert Professor of Pediatrics at Boston University School of Medicine, discusses how by working together, ...

ACP and SGIM find the PCMH model aligns with principles of medical ethics and professionalism

July 30, 2012
The American College of Physicians (ACP) and the Society of General Internal Medicine (SGIM) explore the ethical dimensions of the patient-centered medical home (PCMH) in a new position paper published by the Journal of General ...

Health-care model improves diabetes outcomes, health

July 13, 2011
(Medical Xpress) -- A health-care delivery model called patient-centered medical home (PCMH) increased the percentage of diabetes patients who achieved goals that reduced their sickness and death rates, according to health ...

Higher medical home performance rating of community health centers linked with higher operating cost

June 25, 2012
Federally funded community health centers with higher patient-centered medical home ratings on measures such as quality improvement had higher operating costs, according to a study appearing in JAMA. This study is being published ...

Recommended for you

Number of older people with four or more diseases will double by 2035, say researchers

January 23, 2018
A study published today in Age and Ageing, the scientific journal of the British Geriatrics Society, reports that the number of older people diagnosed with four or more diseases will double between 2015 and 2035. A third ...

Placental accumulation of flame retardant chemical alters serotonin production in rats

January 22, 2018
A North Carolina State University-led research team has shown a connection between exposure to a widely used flame retardant chemical mixture and disruption of normal placental function in rats, leading to altered production ...

Marijuana use does not lower chances of getting pregnant

January 22, 2018
Marijuana use—by either men or women—does not appear to lower a couple's chances of getting pregnant, according to a new study led by Boston University School of Public Health (BUSPH) researchers.

Women run faster after taking newly developed supplement, study finds

January 19, 2018
A new study found that women who took a specially prepared blend of minerals and nutrients for a month saw their 3-mile run times drop by almost a minute.

Americans are getting more sleep

January 19, 2018
Although more than one in three Americans still don't get enough sleep, a new analysis shows first signs of success in the fight for more shut eye. According to data from 181,335 respondents aged 15 and older who participated ...

Wine is good for you—to a point

January 18, 2018
The Mediterranean diet has become synonymous with healthy eating, but there's one thing in it that stands out: It's cool to drink wine.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.