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Identifying Individual and Clinic Characteristics Associated With Primary Care Provider Turnover During
Ashok Reddy1, Charles Maynard, Peter Kaboli
1Center for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington (Drs Reddy, Maynard, Nelson, Liu, Sterling, and Wong); Department of Health Systems and Population Health, University of Washington, Seattle (Drs Reddy, Maynard, Nelson, Liu, and Wong); Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle (Drs Reddy and Nelson); Comprehensive Access and Delivery Research and Evaluation Center at the Iowa City VA Healthcare System and Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City (Dr Kaboli); Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts (Dr Rinne); and Kaiser Permanente Washington Health Research Institute, Seattle, Washington (Dr Henrikson).
Abstract:
Understanding which factors predict primary care provider (PCP) turnover can help organizations prepare for PCP shortages. We conducted a retrospective cohort study of Veteran Health Administration PCPs between 2012 and 2016. We analyzed whether 7 domains of the patient centered medical home (PCMH) implementation-including access, care coordination, comprehensiveness, self-management support, communication, shared decision-making, and team-based care-were associated with PCP turnover. We found that 2 domains of PCMH (access and self-management) were associated with lower turnover, which may reflect that practice cultures that support these characteristics may lower PCP turnover.
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