Ambulatory office organization for internal medicine resident medical education

摘要: PURPOSE: Residents will most effectively learn about ambulatory, systems-based practice by working in highly functional ambulatory practices; however, systems experiences training are thought to be variable. The authors sought determine the prevalence of functional-practice characteristics at clinics where residents learn. METHOD: In 2007, conducted a national survey medical directors resident continuity using comprehensive, Web-based instrument that included both residency clinic assessment and system (PSA). designed PSA estimate Physician Practice Connections (PPC) score, indicating readiness function as patient-centered home (PCMH). RESULTS: Of 356 or physician representatives responding an initial inquiry, 221 completed (62%)--representing 185 programs (49% accredited programs). majority were hospital based (139/220; 63%) supported (41/220; 19%) located urban settings (151/217; 70%). Estimated payer mix categories Medicare managed (169; 29%), Medicaid (161; 34%), self-pay (156; 25%). mean estimated PPC score was 53 points (of 100; SD = 17.6). Suburban rural clinics, Veterans Affairs' federally qualified health centers, with higher proportion patients commercial insurance earned scores. CONCLUSIONS: A substantial portion have elements needed for PCMH recognition. However, struggled connecting these coordination-of-care processes, suggesting areas improvement support better functioning practices.