Family Practices in Germany: a Medical Home for Patients with Chronic Illness?
DOI: 10.3238/zfa.2013.0317-0324german translation / full article
Background: In its 2009 special report, the German Advisory Council on the Assessment of Developments in the Health Care System presented the Patient-Centered Medical Home (PCMH). The PCMH is popular in the U.S. and was described in the report as a possible means of contributing to the development of a coordinated and population-based health care model in Germany that would benefit particularly chronically ill and multimorbid patients.
Method: In an international study, chronically ill patients in single-handed and group practices in South Hesse were asked about the implementation of defined PCMH elements in their family practice. The influence of patient, doctor and practice characteristics on this assessment was then examined using multilevel modelling.
Results: 1848 patients were recruited from 36 family practices. 94 % of those surveyed described the quality of their family practice as good to excellent. Cooperation with social services, the use of internet and email to communicate with patients, the doctor’s interest in the patient’s psychosocial situation and self management support were seen as areas with improvement potential. The patient’s age, education and national origin, number of diseases and medical consultations, the number of doctors in the practice, and practice location, had an influence on surveyed patients’ views.
Conclusion: From the patients’ perspective, important elements of the PCMH concept are well-established in family practices. The PCMH model’s patient-oriented and disease-spanning approach offers further opportunities to improve health care for chronically ill and multimorbid patients in Germany.