Poster Presentations (Group II)

The Institute of Medicine identifies patient centeredness as a core component of quality health care.  Patient centeredness is defined as: “[H]ealth care that establishes a partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patients’ wants, needs, and preferences and that patients have the education and support they need to make decisions and participate in their own care.”[i] Patient centeredness “encompasses qualities of compassion, empathy, and responsiveness to the need, values, and expressed preferences of the individual patient.”[ii]
The NHDR includes one core measure of patient centeredness—a composite measure on the patient experience of care—and two new supplemental measures.  Because having a diverse workforce of health care providers may be an important component of patient centered health care for many patients, the report includes supplemental measures of workforce diversity—race/ethnicity of the Nation’s physician and registered nurse (RN) workforce.  A supplemental measure focusing on health literacy of U.S. adults is also presented.

Findings:
Measures of patient centered care in the National Healthcare Disparities Report include:
1)      Adult ambulatory patients who reported poor communication with health providers (Medical Expenditure Panel Survey, 2004)

- In 2004, Blacks and Asians were more likely than Whites to report they had poor communication with their health providers (11.3% for Blacks and 14.3% for Asians compared with 9% for Whites).  The proportion was higher for Hispanics than for non-Hispanic Whites (12.2% compared with 8.7%) and was higher for poor people than for high income people (15.8% compared with 7.6%). 

- Data shows that socioeconomic status explains some but not all of the racial and ethnic differences in patient-provider communication.

2)      Race/ethnicity of U.S. registered nurses versus the U.S. population (National Sample Survey of Registered Nurses, 2004)

- In 2004, 81.8% of registered nurses in the United States were White.  Relative to the U.S. population, Hispanic, Black, Asian, and American Indian/Alaska Native individuals were underrepresented in the RN workforce while Whites were overrepresented.b.      From 1980 to 2004, the number of racial/ethnic minority RNs increased threefold, from 119,512 to 311,177.  Despite high rates of increase in the number of racial/ethnic minority RNs, the percentage of racial/ethnic minority RNs in the total RN workforce rose only from 7.3% in 1980, to 11.6% in 2004.

3)      Adults in each health literacy level, by race and ethnicity (National Assessment of Adult Literacy, Health Literacy Component, 2003)

- Only 12% of adults had proficient health literacy.  In other words, nearly 9 in 10 adults may lack the skills needed to manage their health and prevent disease. 

- Hispanic adults were 4.6 times more likely than White adults to have below basic health literacy.  Black and American Indian/Alaska Native adults were almost three times more likely than White adults to have below basic health literacy.

4)      Percent of adults with limited English proficiency who had a usual source of care with language assistance (Medical Expenditure Panel Survey, 2003-2004)

- Approximately half (46%) of individuals with limited English proficiency had a usual source of care that offered language assistance in 2004.