Development of a Safety Net Medical Home Scale for Clinics

Background Existing tools to measure patient-centered medical home (PCMH) adoption are not designed for research evaluation in safety-net clinics. Objective Develop a scale to measure PCMH adoption in safety-net clinics. Research Design Cross-sectional survey. Subjects Sixty-five clinics in five states. Main Measures Fifty-two-item Safety Net Medical Home Scale (SNMHS). The total score ranges from 0 (worst) to 100 (best) and is an average of multiple subscales (0–100): Access and Communication, Patient Tracking and Registry, Care Management, Test and Referral Tracking, Quality Improvement, and External Coordination. The scale was tested for internal consistency reliability and tested for convergent validity using The Assessment of Chronic Illness Care (ACIC) and the Patient-Centered Medical Home Assessment (PCMH-A). The scale was applied to centers in the sample. In addition, linear regression models were used to measure the association between clinic characteristics and medical home adoption. Results The SNMHS had high internal consistency reliability (Cronbach’s alpha = 0.84). The SNMHS score correlated moderately with the ACIC score (r = 0.64, p