Assessing the Associations of Patient-Reported Perceptions of Patient-Centered Care as Supplemental Measures of Health Care Quality in VA

Finnish institute for health and welfare is developing national health care quality registers for the ongoing project in 2018–2020, which covers seven disease pilot registers. This article describes professionals’ and patient associations’ cultural health care quality conceptions at developing process, reflecting to Weick’s sensemaking theory and patient-centered care. Research data ( N = 13) were collected by individual thematic semi-structured interviews from pilot registers’ professionals and patient associations. Data were analyzed using the discursive approach. Six main discourses on the shared sociocultural meanings of health care quality were constructed: confidence and reliability, information and understanding, safety and medical effectiveness, support, benchmarking and utility, and requirement and justice. Health care quality is built-in culture and action to achieve patient-centered care and is complex to define. Patient–clinician interaction, understanding, and support are constructive elements to make sense of quality registers’ necessity and data collection. The importance of Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) measures is recognized to strengthen the patient-centeredness, which reflects to all health care decision-making, processes, and care. The data publication should be designed clearly and visually versatile. The study can offer new aspects for selecting valid quality indicators to produce comprehensive information for health care quality registers.

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Patient Advocacy for Health Care Quality: Strategies for Achieving Patient-centered Care

International Journal of Health Care Quality Assurance ◽

10.1108/ijhcqa.2008.06221gae.002 ◽

2008 ◽

Vol 21 (7) ◽

Keyword(s):

Health Care ◽

Health Care Quality ◽

Patient Advocacy ◽

Patient Centered Care ◽

Care Quality ◽

Patient Centered ◽

Centered Care

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Patient Advocacy for Health Care Quality: Strategies for Achieving Patient-centered Care

International Journal of Health Care Quality Assurance ◽

10.1108/ijhcqa.2009.06222cae.004 ◽

2009 ◽

Vol 22 (3) ◽

Keyword(s):

Health Care ◽

Health Care Quality ◽

Patient Advocacy ◽

Patient Centered Care ◽

Care Quality ◽

Patient Centered ◽

Centered Care

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Digital Medicine

Advances in Healthcare Information Systems and Administration - Design, Development, and Integration of Reliable Electronic Healthcare Platforms ◽

10.4018/978-1-5225-1724-5.ch011 ◽

2017 ◽

pp. 179-195

Author(s):

Anastasius Moumtzoglou

Keyword(s):

Health Care ◽

Cultural Competence ◽

Health Care Quality ◽

Patient Centered Care ◽

Care Quality ◽

Patient Centered ◽

Digital Medicine ◽

Centered Care ◽

Quality Dimensions ◽

Patient Values

Individualizing care must take into account the diversity of patient values and perspectives while attending to the specific needs of people must take into account the multifaceted nature of culture. Digital medicine enables digital proximity and self-care, challenges the traditional paternal model of medicine, reshapes the nature and expectations of health care delivery, emphasizes the active involvement of patients and has an enormous potential to empower patients. Moreover, the concepts of bio-objects, cultural competence, and patient-centered care could be apparently thought on a continuum with one pole representing the bio-objects and the other representing one of the health care quality dimensions, patient-centered care. All-embracing, digital medicine affects the core values of cultural competence, which are shared by patient-centered care, one of the health care quality dimensions.

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The Impact of Job Role on Health-Care Workers’ Definitions of Patient-Centered Care

Journal of Patient Experience ◽

10.1177/2374373520910335 ◽

2020 ◽

Vol 7 (6) ◽

pp. 1634-1641

Author(s):

Jessica L Moreau ◽

Alison B Hamilton ◽

Elizabeth M Yano ◽

Lisa V Rubenstein ◽

Susan E Stockdale

Keyword(s):

Health Care ◽

Health Care Workers ◽

Patient Centered Care ◽

Care Quality ◽

System Level ◽

Patient Contact ◽

Patient Centered ◽

Care Workers ◽

Centered Care ◽

The Impact

While patient-centered care (PCC) is a widely accepted aspect of health-care quality, its definition is still the subject of debate. We investigated health-care workers’ definitions of PCC by level of patient contact in job roles. Our qualitative study involved semi-structured interviews with key stakeholder employees (n = 66) at 6 Veterans’ Affairs health-care locations in Southern California. Interviews were recorded, transcribed, coded for definitions of PCC, and analyzed by participants’ self-described level of patient contact. Stakeholders whose role primarily involved patient contact tended to define PCC through: patient as a person, patient preferences, and shared decision-making. Stakeholders whose role did not primarily involve patient contact tended to define PCC through: patient-centered redesign, customer service, and access to services. Stakeholders with more patient contact emphasized patient-level and interpersonal concepts, while those with less patient contact emphasized system-level and business-oriented concepts. The focus on PCC-as-access may reflect influence of changing institutional climate on definitions of PCC for some stakeholders. To facilitate successful PCC efforts, health-care systems may need to leverage differing but complementary definitions of PCC within its workforce.

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Patient-Centered, Integrated Health Care Quality Measures Could Improve Health Literacy, Language Access, and Cultural Competence

NAM Perspectives ◽

10.31478/201902a ◽

2019 ◽

Cited By ~ 3

Author(s):

Ignatius Bau ◽

Robert A. Logan ◽

Christopher Dezii ◽

Bernard Rosof ◽

Alicia Fernandez ◽

...

Keyword(s):

Health Care ◽

Quality Improvement ◽

Health Literacy ◽

Cultural Competence ◽

Health Care Quality ◽

Care Quality ◽

National Committee ◽

Patient Centered ◽

Organizational System ◽

Language Access

The authors of this paper recommend the integration of health care quality improvement measures for health literacy, language access, and cultural competence. The paper also notes the importance of patient-centered and equity-based institutional performance assessments or monitoring systems. The authors support the continued use of specific measures such as assessing organizational system responses to health literacy or the actual availability of needed language access services such as qualified interpreters as part of overall efforts to maintain quality and accountability. Moreover, this paper is informed by previous recommendations from a commissioned paper provided by the National Committee for Quality Assurance (NCQA) to the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. In the commissioned paper, NCQA explained that health literacy, language access, and cultural competence measures are siloed and need to generate results that enhance patient care improvements. The authors suggest that the integration of health literacy, language access, and cultural competence measures will provide for institutional assessment across multiple dimensions of patient vulnerabilities. With such integration, health care organizations and providers will be able to cultivate the tools needed to identify opportunities for quality improvement as well as adapt care to meet diverse patients’ complex needs. Similarly, this paper reinforces the importance of providing more “measures that matter” within clinical settings.

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Concordance and Patient-Centered Care in Medicaid Enrollees’ Care Experience With Providers

Journal of Patient Experience ◽

10.1177/23743735211034028 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110340

Author(s):

Iwimbong Kum Ghabowen ◽

Neeraj Bhandari

Keyword(s):

Health Care ◽

Health Care Access ◽

Patient Centered Care ◽

Care Utilization ◽

Federal State ◽

Patient Centered ◽

Care Experience ◽

Centered Care ◽

State And Local ◽

Privately Insured

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, controlling for sociodemographic factors, health care access, and health care utilization of respondents. Compared to Medicare and privately insured enrollees, Medicaid enrollees reported much lower odds of seeing providers who treated them with respect (OR = 1.91, P < .001; OR = 1.62, P < .01) and who offered PCC (OR = 1.35, P < .05; OR = 1.35, P < .01), but similar odds of seeing concordant providers (OR = 0.78, P = .96; OR = 0.96, P = .72). Importantly, Medicaid enrollees reported higher odds of seeing providers who solicited their opinion/beliefs/preferences than their Medicare or privately insured counterparts (OR = 0.82, P < .05; OR = 0.87 P < .10). Medicaid enrollees report less patient-centered experiences in some important facets of their provider interaction than their Medicare or privately insured counterparts. Federal, state, and local policies and practices directed at improving these facets of patient–provider interaction are needed and should be aimed squarely at Medicaid providers, especially those working in geographic areas and settings with a disproportionate number of racial, gender, cultural, and linguistic minorities.

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Abstract 002: Patient Provider Communication and Patient-centered Outcomes Among Patients With Atherosclerotic Cardiovascular Disease in United States: Medical Expenditure Panel Survey 2010-2013

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.002 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Victor Okunrintemi ◽

Erica Spatz ◽

Joseph Salami ◽

Haider Warraich ◽

Salim Virani ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Medical Expenditure Panel Survey ◽

Medical Expenditure ◽

Atherosclerotic Cardiovascular Disease ◽

Care Providers ◽

Patient Centered ◽

Patient Reported ◽

Centered Care ◽

Nationally Representative

Background: With recent enactment of Accountable Care Act, consumer reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey (CAHPS) in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD). Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. Participants responded to questions from CAHPS that assess satisfaction with PPC (four-point response scale: never, sometimes, usually, always ) :(1) “How often providers show respect for what you had to say” (2) “How often health care providers listened carefully to you” (3) “How often health care providers explained things so you understood” (4) “How often health providers spent enough time with you” We developed a weighted PPC composite score, categorized as 1 ( never / sometimes ), 2 ( usually ), and 3 ( always ). Outcomes of interest were 1) patient reported outcomes (PRO): SF-12 physical/mental health status, 2) quality of care measures: statin and ASA use, 3) health-care resource utilization (HRU): Emergency room visits & hospital stays, 4) total annual and out of pocket healthcare expenditures (HCE). Results: As shown in the table, those with ASCVD reporting ineffective (never/sometimes) vs. effective PCC (always) were over 2-fold more likely to report poor PRO, 34% & 22% less likely to report statin and ASA use respectively, had a significantly greater HRU (OR≥ 2 ER visit: 1.40 [95% CI:1.09-1.80], OR≥ 2 hospitalization: 1.35 [95% CI:1.02-1.77], as well as an estimated $1,294 ($121-2468) higher annual HCE. Conclusion: This study reveals a strong relationship between patient-physician communication among those with established ASCVD with patient-reported outcomes, utilization of evidence based therapies, healthcare resource utilization and expenditures.

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