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 Overview
Based on The Primary Provider Theory© below, the Provider Patient-Centeredness and Disparities Outcome Measurement Initiative is a 5-year, $700,000 grant based on psychometric research that will be translated into outcomes to help reduce disparities and increase the number of patient-centered health care providers caring for minority patients, women, and children.
Principal Investigator
STEPHEN J. ARAGON, PhD
Associate Professor, Healthcare Management & Measurement
The School of Business and Economics
Winston-Salem State University
Research Fellow
The Sheps Center for Health Services Research
The University of North Carolina
Former AHRQ NRSA Postdoctoral Fellow and Hospital Chief Executive
Specific Aims
The Specific Aims of the Provider Patient-Centeredness and Disparities Outcome Measurement Initiative are:
- Establish that patient-centeredness is an underlying ability of providers.
- Establish that the patient-centeredness of providers affects outcomes across minority patients, women, and children.
- Establish that the effect of patient-centeredness on outcomes is stable across minority patients, women, and children, providers, and settings.
- Develop a patient-centeredness graduate course for medical, nursing, and allied health students.
- Increase the number minority researchers conducting patient-centeredness research.
- Develop a patient-centeredness assessment.
- Develop a patient-centeredness certificate program.
- Conduct annual symposiums disseminating the grant’s research.
Preliminary Empirical Findings
The preliminary findings of the Provider Patient-Centeredness and Disparities Outcome Measurement Initiative are that patient-centeredness is an underlying ability of healthcare providers. Patient-centeredness influences providers’ care behaviors and patient outcomes, including trust, confidence, satisfaction, likelihood to recommend, and patients’ ratings of quality. Unit increases in patient-centeredness concomitantly increase patients’ ratings of their provider’s care behaviors and subsequent outcomes. The influence of providers’ patient-centeredness on their care behavior and their patient’s outcomes appears stable across minority patients, women, and children, providers, and settings.
Investigations In-Progress
The following experimental investigations are currently being conducted by the grant’s principal investigator and collaborators:
- How the patient-centeredness of physicians and nurses affects hospital inpatient satisfaction across national random samples of Black medical, obstetrical, and surgical inpatients.
- How the patient-centeredness of obstetrical nurses affects the satisfaction of Medicaid OB patients across national random samples of such patients.
- How the patient-centeredness of obstetrical nurses affects the satisfaction of Medicaid OB patients across national random samples of such patients.
- How the cardiovascular physicians’ patient-centeredness affects their patient’s trust across two national random cardiovascular patient samples.
- How the patient-centeredness of nurse practitioners, waiting time, and nursing service affect patient satisfaction across two national random samples family practice patients.
- How nurse practitioners’ patient-centeredness 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 pediatricians’ affects family trust, confidence, and their likelihood to recommend across two national random samples of pediatric patients.
- How the patient-centeredness of dentists affects their patients’ reported satisfaction.
Grant Related Presentations
Selected presentations related to the grant include the following:
- Aragon, SJ, The Provider Patient-Centeredness and Disparities Outcome Measurement Initiative, Third National Leadership Summit on Eliminating Racial and Ethnic Disparities in Health Hosted by the Office of Minority Health February 25 - 27, 2009, Washington, D.C.
- Aragon, SJ, Ingram, R., Edwards, S., Lawrence, W., Barber, D., Roberts, D. The Effects of Patient-Centeredness on Patient Trust, Satisfaction, Ratings of Quality and Likelihood to Recommend, The Center of Excellence for the Elimination of Health Disparities, WSSU, November 6, 2008, Winston Salem, North Carolina. http://www.wssu.edu/WSSU/About/Events/Patient-Centered+Care+Symposium.htm
- Aragon, SJ. Patient-Centeredness and Market Justice-Social Justice, Building Capacity to Eliminate Health Disparities: The Founding Meeting of the Academy for Health Equity, June 26-27, 2008, Denver, Colorado
- Aragon, SJ. Patient-Centeredness and Its Robust Effect on Outcomes Across Providers and Patients, Veterans Administration Research Week, Hefner Veterans Administration Medical Center, May 15, 2008, Salisbury, NC
- Aragon, SJ et al, The Primary Provider Theory: A Framework for Measuring Evidence-Based Nursing Outcomes, 18th International Nursing Research Congress Focusing on Evidence-Based Practice, July 11-14, 2007, Vienna, Austria
- Aragon, SJ et al. “Evidence-Based Outcome Measurement: How RNs and NPs Influence Patient's Satisfaction, Trust, Ratings of Care and Likelihood to Recommend,” 39th Sigma Theta Tau Biennial Convention, Vision to Action: Global Health through Collaboration, November 3 - 7, 2007, Baltimore, Maryland
- Aragon, SJ. The Primary Provider Theory: A Paradigm for Measuring Patient-Centeredness and Minority Patient Satisfaction, The National Leadership Summit on Eliminating Racial and Ethnic Disparities in Health January 9-11, 2006, Washington, D.C.
Grant Related Manuscript
- Aragon, SJ, McGuinn LJ, De La Torre, EE, Bavin, SA, Gesell, SB. Pediatric Does Pediatric Patient-Centeredness Affect Family Trust Family Trust: An Evidence-Based Investigation. (In Review).
The Primary Provider Theory©
The Primary Provider Theory© is a generalizable theory of how the patient-centeredness of health providers affects their care behavior, during patient encounters, and related outcomes. Grounded in 20 years of patients’ evaluations of their interactions with providers in hospitals and medical practices, Dr. Aragon developed the Theory during as a hospital chief executive. The Theory is based on the following nine principles that favor patients in healthcare encounters with their providers.
- Clinical competency is a necessary but insufficient condition of desired outcomes.
- Desired outcomes require more than clinical competency alone, because the transmission of care and clinical knowledge require effective communication and interaction with patients.
- Patient-centeredness is an underlying ability that influences the quality of provider’s interaction with and transmission of care to patients.
- Providers’ patient-centeredness influences the outcomes of their patients.
- Providers are uniquely responsible for the quality of the transmission of their care and clinical knowledge to patients.
- Providers who are both clinically competent and patient-centered are more likely to achieve desired outcomes.
- Patients and families value the patient-centeredness of their providers.
- The patient-centeredness of the provider is more important than the financial objectives of a patient encounter.
- Patients are the best judges of the patient-centeredness of their providers.
Note: The above Principles support the scientific method and Hippocratic Oath.
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