Volume 53 | Number 4 | August 2018

Abstract List

Ann‐Marie Rosland M.D., M.S., Edwin Wong Ph.D., Matthew Maciejewski Ph.D., Donna Zulman M.D., M.S., Rebecca Piegari M.S., Stephan Fihn M.D., M.P.H., Karin Nelson M.D., M.S.H.S.


To examine associations between clinics’ extent of patient‐centered medical home () implementation and improvements in chronic illness care quality.

Data Source

Data from 808 Veterans Health Administration () primary care clinics nationwide implementing the Patient Aligned Care Teams () initiative, begun in 2010.


Clinic‐level longitudinal observational study of clinics that received training and resources to implement . Clinics varied in the extent they had components in place by 2012.

Data Collection

Clinical care quality measures reflecting intermediate outcomes and care processes related to coronary artery disease (), diabetes, and hypertension care were collected by manual chart review at each facility from 2009 to 2013.


In adjusted models containing 808 clinics, the 77 clinics with the most components in place had significantly larger improvements in five of seven chronic disease intermediate outcome measures (e.g.,  < 160/100 in diabetes), ranging from 1.3 percent to 5.2 percent of the patient population meeting measures, and two of eight process measures (HbA1c measurement, measurement in ) than the 69 clinics with the least components. Clinics with moderate levels of components showed few significantly larger improvements than the lowest clinics.


Veterans Health Administration primary care clinics with the most components in place in 2012 had greater improvements in several chronic disease quality measures in 2009–2013 than the lowest clinics.