How Physician and Nursing Patient-Centered Behaviors Influence African-American and Black Female Medicaid Patients' Satisfaction

Tuesday, 1 November 2011: 9:05 AM

Stephen J. Aragon, PhD, MHA, BS
School of Health Sciences- Department of Nursing, Winston-Salem State University, Winston-Salem, NC
Laura McGuinn, MD
Nursing, University of Oklahoma Health Sciences Center, OK

African American and Black Female Medicaid Patients deserve interpersonal competency as well as technical clinical ability from their health providers. This important element of healthcare, called patient-centeredness, is the ability of health providers that affects the quality of their interaction with patients and consequently outcomes. OBJECTIVES: The purposes of this study were to determine (a) how physician and nursing patient-centered behaviors influenced African American and Black Female Medicaid patient satisfaction, likelihood to recommend the hospital and ratings of care, and (b) whether the effects were stable across national random samples. METHODS: Using randomly selected test (N1=98) and cross-validation (N2=296) samples a three-factor multigroup structural equation modeling design was employed, with a post hoc competing model challenge to further test the hypothesized model’s trustworthiness. RESULTS: The model fit, providing evidence that physician and nursing patient-centered behaviors influence African American and Black Female Medicaid patients’ satisfaction, accounting for 73% of its variance. A standardized increase in physician patient-centeredness increased female patients’ satisfaction, likelihood to recommend to recommend the hospital and ratings of care by .698, .665, and .644 units respectively, while the effects for nursing were .643, .613, and .594. These effects were stable (invariant) across both the test and cross-validation samples. When the competing model was when compared to the hypothesized model, the latter was sustained. DISCUSSION: This study demonstrated that physician and nursing patient-centeredness increased African American and Black Female Medicaid patients’ satisfaction, likelihood to recommend the hospital, and overall ratings of hospital care. The Primary Provider Theory and this study offer evidence-based models for future research with implications for the measurement and improvement of African American and Black Female Medicaid patients’ satisfaction, likelihood to recommend, ratings of care, physician and nursing patient-centeredness, and disparities prevention.