The missed opportunity of patient-centered medical homes to thrive in an Asian context
In recent years, there is growing interest internationally to implement patient-centered medical homes (PCMHs), and Singapore is no exception. However, studies understanding the influence of contextual policy factors on the implementation of PCMHs are limited. We conducted 10 semi-structured in-dept...
| Main Authors: | , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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2021
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| Online Access: | https://hdl.handle.net/10356/152094 |
| _version_ | 1811689434450493440 |
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| author | Surendran, Shilpa Foo, Chuan De Tam, Chen Hee Ho, Elaine Qiao Ying Matchar, David Bruce Car, Josip Koh, Gerald Choon Huat |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Surendran, Shilpa Foo, Chuan De Tam, Chen Hee Ho, Elaine Qiao Ying Matchar, David Bruce Car, Josip Koh, Gerald Choon Huat |
| author_sort | Surendran, Shilpa |
| collection | NTU |
| description | In recent years, there is growing interest internationally to implement patient-centered medical homes (PCMHs), and Singapore is no exception. However, studies understanding the influence of contextual policy factors on the implementation of PCMHs are limited. We conducted 10 semi-structured in-depth interviews with general practitioners working in seven out of the nine PCMHs. Audio recordings were transcribed and analyzed by two study team members in NVivo 12 Software using grounded theory techniques. Power dynamics between the stakeholders and lack of shared decision-making among them in selecting the locale of the PCMH and formulating the practice fee and pharmacy structure were the key factors which negatively affected the implementation of PCMHs on a larger scale. Over time, lack of funding to hire dedicated staff to transfer patients and misalignment of various stakeholders’ interest to other right-siting programs also resulted in low number of patients with chronic conditions and revenue. Countries seeking to implement a successful PCMH may benefit from building trust and relationship between stakeholders, engaging in shared decision-making, ongoing cost-efficiency efforts, and formulating a clear delineation of responsibilities between stakeholders. For a healthcare delivery model to succeed in the primary care landscape, policies should be developed keeping mind the realities of primary care practice. |
| first_indexed | 2024-10-01T05:48:02Z |
| format | Journal Article |
| id | ntu-10356/152094 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T05:48:02Z |
| publishDate | 2021 |
| record_format | dspace |
| spelling | ntu-10356/1520942023-03-05T16:44:06Z The missed opportunity of patient-centered medical homes to thrive in an Asian context Surendran, Shilpa Foo, Chuan De Tam, Chen Hee Ho, Elaine Qiao Ying Matchar, David Bruce Car, Josip Koh, Gerald Choon Huat Lee Kong Chian School of Medicine (LKCMedicine) Centre for Population Health Sciences Science::Medicine Patient-Centered Medical Home Primary Care In recent years, there is growing interest internationally to implement patient-centered medical homes (PCMHs), and Singapore is no exception. However, studies understanding the influence of contextual policy factors on the implementation of PCMHs are limited. We conducted 10 semi-structured in-depth interviews with general practitioners working in seven out of the nine PCMHs. Audio recordings were transcribed and analyzed by two study team members in NVivo 12 Software using grounded theory techniques. Power dynamics between the stakeholders and lack of shared decision-making among them in selecting the locale of the PCMH and formulating the practice fee and pharmacy structure were the key factors which negatively affected the implementation of PCMHs on a larger scale. Over time, lack of funding to hire dedicated staff to transfer patients and misalignment of various stakeholders’ interest to other right-siting programs also resulted in low number of patients with chronic conditions and revenue. Countries seeking to implement a successful PCMH may benefit from building trust and relationship between stakeholders, engaging in shared decision-making, ongoing cost-efficiency efforts, and formulating a clear delineation of responsibilities between stakeholders. For a healthcare delivery model to succeed in the primary care landscape, policies should be developed keeping mind the realities of primary care practice. Ministry of Health (MOH) National Medical Research Council (NMRC) Published version This research was funded by the National Medical Research Council (NMRC) and Ministry of Health, Singapore, Health Service Research Grant (HSRG), grant number NMRC/HSRG/0086/2018 and the Centre Grant Program Singapore Population Health Improvement Centre, grant number: NMRC/CG/C026/2017_NUHS. 2021-11-18T09:00:07Z 2021-11-18T09:00:07Z 2021 Journal Article Surendran, S., Foo, C. D., Tam, C. H., Ho, E. Q. Y., Matchar, D. B., Car, J. & Koh, G. C. H. (2021). The missed opportunity of patient-centered medical homes to thrive in an Asian context. International Journal of Environmental Research and Public Health, 18(4), 1817-. https://dx.doi.org/10.3390/ijerph18041817 1660-4601 https://hdl.handle.net/10356/152094 10.3390/ijerph18041817 33668610 2-s2.0-85100793988 4 18 1817 en NMRC/HSRG/0086/2018 NMRC/CG/C026/2017_NUHS International Journal of Environmental Research and Public Health © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). application/pdf |
| spellingShingle | Science::Medicine Patient-Centered Medical Home Primary Care Surendran, Shilpa Foo, Chuan De Tam, Chen Hee Ho, Elaine Qiao Ying Matchar, David Bruce Car, Josip Koh, Gerald Choon Huat The missed opportunity of patient-centered medical homes to thrive in an Asian context |
| title | The missed opportunity of patient-centered medical homes to thrive in an Asian context |
| title_full | The missed opportunity of patient-centered medical homes to thrive in an Asian context |
| title_fullStr | The missed opportunity of patient-centered medical homes to thrive in an Asian context |
| title_full_unstemmed | The missed opportunity of patient-centered medical homes to thrive in an Asian context |
| title_short | The missed opportunity of patient-centered medical homes to thrive in an Asian context |
| title_sort | missed opportunity of patient centered medical homes to thrive in an asian context |
| topic | Science::Medicine Patient-Centered Medical Home Primary Care |
| url | https://hdl.handle.net/10356/152094 |
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