IJERPH, Vol. 18, Pages 1817: The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context

IJERPH, Vol. 18, Pages 1817: The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context International Journal of Environmental Research and Public Health doi: 10.3390/ijerph18041817 Authors: Shilpa Surendran Chuan De Foo Chen Hee Tam Elaine Qiao Ying Ho David Bruce Matchar Josip Car Gerald Choon Huat Koh 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 s...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research