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The Influence of Patient-Centeredness on Asian Patients’ Satisfaction, Likelihood to Recommend, and Ratings of Quality. Stephen J. Aragon AMERICAN SOCIETY OF BUSINESS AND BEHAVIORAL SCIENCES 18 th ANNUAL MEETING, LAS VEGAS, NEVADA FE2BRUARY 24-27, 2011.
Stephen J. Aragon
AMERICAN SOCIETY OF BUSINESS AND BEHAVIORAL SCIENCES
18th ANNUAL MEETING, LAS VEGAS, NEVADA
FE2BRUARY 24-27, 2011
The research upon which this presentation is based was sponsored by The National Institutes of Health National and Center on Minority Health and Health Disparities through The Provider Patient-Centeredness and Disparities Outcome Measurement Initiative (NIH/NCMHD-1P20MD002303-04).
I certify that neither I nor any member of my family has a material financial relationship, bias or ethical conflict, which will prevent me from making this presentation solely on the basis of its merits.
Stephen J. Aragon, PhD, MHA
The Underlying Theory
Some empirical evidence supporting patient-centeredness’ influence on outcomes
Closing comments and answer questions
5-year $700,000 grant funding empirical research, which will be translated into outcomes to help improve quality and reduce disparities for minority patients, women, and children
Establish that patient-centeredness is an underlying ability of healthcare providers
Establish that the patient-centeredness of health providers affects the outcomes of minority patients, women, and children
Establish that the effect of provider patient-centeredness on outcomes is stable across patients, providers, and settings
Develop a patient-centeredness graduate course for medical, nursing, and allied health students
Develop a patient-centeredness certificate program for health providers
Develop an inventory for measuring the patient-centeredness of health providers
Increase the number of minority researchers involved in patient-centeredness research
Conduct annual patient-centeredness symposiums
The Primary Provider TheoryAn evidence-based generalizable theory of how the patient-centeredness of health providers affects desired outcomes
Developed from observations and interviews with patients in hospitals and medical practices
It is exclusively based on principles that favor patients in healthcare encounters
Clinical competency is a necessary but insufficient condition of desired health outcomes.
Desired outcomes require more than clinical competency alone, because delivery of medical care requires interaction with patients.
The sourceof patient-centered care is patient-centered providers, not proclamations, policies, or procedures.
Patient-centeredness is the ability of health providers that affects the quality of their interaction with patients.
Providers are solely responsible for the quality of their interaction with their patients.
Patients and their families value both the patient-centeredness and clinical competency of providers.
Providers who are patient-centered and clinically competent are more likely to achieve desired outcomes.
Healthcare providers must, above all else, protect the best interests of their patients first.
The patient-centeredness of healthcare providers is more important than profit in any single health encounter.
Patients are the best judges of the patient-centeredness of their providers.
Empathetic, communicative, interested in patient’s feelings
Tactful, skilled in relationships with patients
Grasp patients’ needs, preferences, values, and concerns
Protect patient’s best interests above all else
Earn patients’ trust, satisfaction, confidence, high ratings, loyalty
Aloof, uncommunicative, less interested in patient’s feelings
Less tactful and skilled in relationships with patients
Less concerned with patient’s needs, preferences, values, and concerns
Subordinate patient’s best interests to other interests
Tend not to earn patients’ trust, satisfaction, confidence, high ratings, loyaltyPatient-Centeredness IQ
*Note: High patient-centeredness ability reflects emotional stability, agreeableness, conscientiousness, ethical behavior, interpersonal sensitivity, while low ability reflects more dysfunctional dispositions or relationship derailers, e.g., moody, inconsistent, cynical, distrustful, indifferent, prejudices, critical of others, etc., and personality disorders.
Empirical EvidenceSupporting the hypothesis that patient-centeredness is an ability of healthcare providers that affects the quality of their interaction with patients and related outcomes
Does Pediatric Patient-Centeredness Affect Family Trust? Aragon, S. J., McGuinn, L., Bavin, S. A. and Gesell, S. B., Does Pediatric Patient-Centeredness Affect Family Trust? Journal for Healthcare Quality, 32: 23–31, May/June 2010. http://onlinelibrary.wiley.com/doi/10.1111/j.1945-1474.2010.00092.x/full
Does nursing patient-centeredness affect Medicaid patient satisfaction?
If yes, how much?
Is the influence of patient-centeredness stable across samples?
N1 Friendliness and courtesy
N5 Kept patient informed
N3 Attitude toward requests
N4 Amount of attention
Medicaid Patient Satisfaction
03 Likelihood of recommending hospital
04 Overall rating of care
Total N = 605
Group 1, N = 294
Group 2, N = 311
The model fit. Pediatric physician patient-centeredness significantly affected (.95) family trust.1, 2
It explained 89% of family trust.1
2 = 64.87, df = 69, p = .619; RMSEA = .000, p = 1.00; CFI = 1.00; R2 = .89
p < .001
The effect was stable across both samples.3,4
The model held versus the competing model.4
Gender had no significant effect on family trust.5
p < .001
2 = 13.94, df = 17, p = .671
P > .62
The patient-centeredness of pediatricians significantly positively influenced their (1) care behaviors with patients and (2) increased family trust, confidence, and the likelihood to recommend the pediatrician to others by .946, .904, and .863 across both samples.
Offers another path to help prevent and overcome disparities.
Provides empirical evidence that the patient-centeredness of providers affects desired outcomes for minority patients, women, and children.
Will establish the yard stick for measuring the patient-centeredness of providers for assessment, selection, and training to improve quality.
Will help increase the number of minority patient-centeredness researchers.
Can help increase the number of patient-centered providers over time.
How the patient-centeredness of obstetrical nurses affects the satisfaction of Medicaid OB patients
How the patient-centeredness of physicians and nurses affects the satisfaction of Black and African American female medical, obstetrical, and surgical inpatients
How physician and nursing patient-centeredness affects male American Indian and Alaskan Native patient satisfaction, likelihood to recommend, and ratings of care
How nursing patient-centeredness affects the satisfaction of Black and African American female Medicare patients’ satisfaction
How the patient-centeredness of physicians affects Asian patient satisfaction, likelihood of recommending the hospital, and ratings of care
How the patient-centeredness of nurse practitioners affects patient trust, confidence and likelihood to recommend across national random samples of pediatric, internal medicine and family practice patients
How the patient-centeredness of cardiovascular physicians affects patient trust, confidence, and loyalty
How the patient-centeredness of nurse practitioners, waiting time, and nursing affects the likelihood to return of female family practice patients
How the patient-centeredness of pediatricians affects family trust, confidence, and likelihood to recommend the pediatrician