Comparison of quality metrics in an education-centered medical home with local and national benchmarks

将以教育为中心的医疗之家质量指标与地方和国家基准进行比较

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Abstract

The Education-Centered Medical Home (ECMH) is a longitudinal clerkship where students provide care to patients at one clinic site for the entirety of medical school. Studies have demonstrated that ECMHs have higher completion rates of preventative measures than traditional student-run free clinics (SRFCs). However, data comparing ECMHs with licensed primary care provider clinics are limited. We performed a prospective chart review that examined vaccination and cancer screening rates of patients in an ECMH and those seen by primary care physicians (PCPs) at the same free clinic site. We then compared these groups with participants in the 2018 National Health Information Study (NHIS). A total of 62 ECMH patients, 3,515 PCP patients, and 25,045 NHIS participants were included in the study. Within the ECMH, 72.7% and 80.0% of patients were screened for breast and cervical cancer, respectively. These rates did not differ significantly from those of PCP patients or NHIS participants. While the percentage of ECMH patients screened for colon cancer was similar to that of PCP patients (78.9% vs. 65.8%, p = 0.09), it was proportionally greater than NHIS screening rates (78.9% vs. 63.3%, p = 0.043). In addition, the rate of influenza and pneumococcal pneumonia vaccination among ECMH patients (41.4% and 58.3%, respectively) did not differ significantly from the PCP and NHIS groups. Our study found that the ECMH model allows students to deliver preventative care comparable to licensed practitioners and national benchmarks. It reaffirms the ECMH as an effective method for students to provide high quality care to underserved patients.

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