Support for Medical Home Features: Quality of Literature
| Recommendation | Evidence Rating | References | Comments |
|---|---|---|---|
| Patients who have a continuity relationship with a personal care physician have better health process measures and outcomes. | 1 | 23,34,41,47,52 | Continuity is most commonly associated with primary care, but cancer care, dialysis, and diabetes care are examples of specialty continuity. |
| Multiple visits over time with the same provider create renewed opportunities to build management and teaching strategies tailored to individual progress and receptivity. | 2 | 24,25,38,39,46,49,54,55 | Neither primary care nor specialty care can meet their full potential if provided in a vacuum. All studies are challenged to evaluate any piece of the system in isolation from the context of specialty or other community services. |
| Minorities become as likely as non-minorities to receive preventive screening and have their chronic conditions well managed in a medical home model. | 2 | 19,20,22,26,27 | Rigorous program evaluations, secondary population analyses, and observational comparison studies show consistent findings. |
| In primary care, patients present at most visits with multiple problems. | 1 | 06, 64,65 | The use of each office visit to care for multiple problems is a property of primary care. |
| Specialists generate more diagnostic hypotheses within their domain than outside and assign higher probabilities to diagnoses within that domain. | 2 | 73,74 | The interface between primary care and specialty care needs further research. |
| The more attributes of the medical home demonstrated by a primary care practice, the more likely patients are to be up to date on screening, immunizations, and health habit counseling, and the less likely they are to use emergency rooms. | 2 | 28,29,94,95,106,107,121 |
1 = consistent, good quality evidence; 2 = limited quality, patient-oriented evidence; 3 = consensus, usual practice, expert opinion, or case series.30