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In all countries, patients with such medical home relationships reported significantly more positive experiences, including having more time with their doctors, more involvement in care decisions, and better coordination with specialists and hospitals.

Those with a medical home were also much less likely to report medical errors, receiving conflicting information from different doctors or to encounter coordination problems, such as diagnostic tests or medical records not being available at the time of care and duplicate tests.

In the U.S., uninsured adults were at high risk of being without such a connection to the health system: just 26 percent of uninsured compared to 53 percent insured adults under age 65 had a medical home.

The lack of a link to care as well as insurance puts the uninsured at double jeopardy for both inefficient care and access barriers. Health systems designed to create medical homes could help improve patient safety, coordination of care and reduce reliance on emergency rooms, while also improving patient satisfaction, said Commonwealth Fund President Karen Davis. The potential gain has led to endorsement of the medical home concept among U.S. primary care physicians, including the American Academy of Family Physicians and the American Academy of Pediatrics.

The authors conclude, As countries confront the question of how best to organize care systems to achieve higher value, the study highlights the importance and potential of having a relationship with a primary care source with characteristics of a medical home.

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