Outcome measurement in direct primary care

Abstract

The cost of healthcare in the United States compared to the quality of outcomes achieved is disproportionately high. Limitations in access to primary care result in poorer population health, increase in frequency and severity of exacerbations of chronic conditions, higher numbers of emergency room visits, surgical interventions and specialty consultations which increase healthcare expense. A novel model of primary care delivery, Direct Primary Care (DPC), claims anecdotal improvement in cost, access, satisfaction, and clinical outcomes but the results have not been validated in the literature. This project aimed to gain insight to the degree of improvement in access and care outcomes achieved at a direct primary care clinic in Montana. A valid and reliable, patient-reported outcome measure (the Person-Centered Primary Care Measure) was implemented to identify the extent to which this DPC clinic achieved improvements in these areas. The results of this project indicated that efforts in DPC have the capacity to advance population health, improve clinical outcomes and reduce cost through increased access to care. Further evaluation is recommended including repetition of this project in other geographic locales. Others wishing to continue the work may desire to include demographic information such as age, gender and length of practice membership.