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The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context.

Publication ,  Journal Article
Surendran, S; Foo, CD; Tam, CH; Ho, EQY; Matchar, DB; Car, J; Koh, GCH
Published in: Int J Environ Res Public Health
February 13, 2021

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.

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Published In

Int J Environ Res Public Health

DOI

EISSN

1660-4601

Publication Date

February 13, 2021

Volume

18

Issue

4

Location

Switzerland

Related Subject Headings

  • Toxicology
  • Singapore
  • Primary Health Care
  • Patient-Centered Care
  • Humans
  • Grounded Theory
 

Citation

APA
Chicago
ICMJE
MLA
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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. Int J Environ Res Public Health, 18(4). https://doi.org/10.3390/ijerph18041817
Surendran, Shilpa, Chuan De Foo, Chen Hee Tam, Elaine Qiao Ying Ho, David Bruce Matchar, Josip Car, and Gerald Choon Huat Koh. “The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context.Int J Environ Res Public Health 18, no. 4 (February 13, 2021). https://doi.org/10.3390/ijerph18041817.
Surendran S, Foo CD, Tam CH, Ho EQY, Matchar DB, Car J, et al. The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context. Int J Environ Res Public Health. 2021 Feb 13;18(4).
Surendran, Shilpa, et al. “The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context.Int J Environ Res Public Health, vol. 18, no. 4, Feb. 2021. Pubmed, doi:10.3390/ijerph18041817.
Surendran S, Foo CD, Tam CH, Ho EQY, Matchar DB, Car J, Koh GCH. The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context. Int J Environ Res Public Health. 2021 Feb 13;18(4).

Published In

Int J Environ Res Public Health

DOI

EISSN

1660-4601

Publication Date

February 13, 2021

Volume

18

Issue

4

Location

Switzerland

Related Subject Headings

  • Toxicology
  • Singapore
  • Primary Health Care
  • Patient-Centered Care
  • Humans
  • Grounded Theory