Beschreibung

"Hopes are high that the delivery system reforms embodied in the patient-centered medical home (PCMH) will improve the quality of care for patients with chronic diseases. While primary care physicians (PCPs), given their training, will likely be the locus of care under this model, there are certain conditions for which urologists are well suited to provide the continuous and comprehensive care called for by the PCMH. To assess the feasibility of urology-based PCMHs, we analyzed national survey data. For our measure of medical home infrastructure, we mapped items from the 2007 and 2008 National Ambulatory Medical Care Survey (NAMCS) to the National Committee on Quality Assurance (NCQA) standards for PCMH recognition. We then determined the proportion of urology practices in the U.S. that would achieve PCMH recognition. Finally, we used NAMCS data to estimate the impact of consolidating genitourinary (GU) cancer (i.e. prostate, bladder, kidney, and testis) follow-up care among the current supply of urologists. Nearly three quarters of urology practices meet NCQA standards for PCMH recognition. At present, PCPs spend 9,295 cumulative work weeks providing direct and indirect care to survivors of GU cancers. Offloading half of this care to urology practices, in the context of the PCMH, would generate an average of 0.73 additional work weeks for each practicing urologist. Urology practices may possess the capacity needed to direct medical homes for their patients with GU cancers. Successful implementation of this model would likely require a willingness to manage some non-urological conditions." (Author's abstract, IAB-Doku) ((en))