ORIGINAL COMMUNICATION
Patient Centeredness, Cultural Competence and Healthcare Quality

https://doi.org/10.1016/S0027-9684(15)31505-4Get rights and content

Cultural competence and patient centeredness are approaches to improving healthcare quality that have been promoted extensively in recent years. In this paper, we explore the historical evolution of both cultural competence and patient centeredness. In doing so, we demonstrate that early conceptual models of cultural competence and patient centeredness focused on how healthcare providers and patients might interact at the interpersonal level and that later conceptual models were expanded to consider how patients might be treated by the healthcare system as a whole. We then compare conceptual models for both cultural competence and patient centeredness at both the interpersonal and healthcare system levels to demonstrate similarities and differences. We conclude that, although the concepts have had different histories and foci, many of the core features of cultural competence and patient centeredness are the same. Each approach holds promise for improving the quality of healthcare for individual patients, communities and populations.

REFERENCES (35)

  • N. Mead et al.

    Patient-centeredness: a conceptual framework and review of the empirical literature

    Soc Sci Med.

    (2000)
  • L. Bobo et al.

    Principles of intercultural medicine in an internal medicine program

    Am J Med Sci.

    (1991)
  • E. Balint

    The possibilities of patient-centered medicine

    J R Coll Gen Pract.

    (1969)
  • M. Lipkin et al.

    The medical interview: a core curriculum for residencies in internal medicine

    Ann Intern Med.

    (1984)
  • J.H. Levenstein et al.

    The patient-centred clinical method. 1. A model for the doctor-patient interaction in family medicine

    Fam Pract

    (1986)
  • M. Stewart et al.

    Patient-Centered medicine: Transforming the Clinical Method

    (1995)
  • I. McWhinney

    The need for a transformed clinical method

  • M. Gerteis et al.

    Through the Patient’s Eyes: Understanding and Promoting Patient-Centered Care

    (1993)
  • Committee on Quality Health Care in America

    Through the Patient’s Eyes: Understanding and Promoting Patient-Centered Care

    (2001)
  • L.L. Berry et al.

    Innovations in access to care: a patientcentered approach

    Ann Intern Med.

    (2003)
  • J.B. Perlin et al.

    The Veterans Health Administration: quality, value, accountability, and information as transforming strategies for patient-centered care

    Am J Manag Care.

    (2004)
  • P.S. Byrne et al.

    Doctors Talking to Patients: A Study of the Verbal Behaviour of General Practitioners Consulting in Their Surgeries

    (1976)
  • C. Laine et al.

    Patient-centered medicine: a professional evolution

    JAMA.

    (1996)
  • American Medical Association

    Cultural Competence Compendium

    (1999)
  • Office of Minority Health

    National Standards on Culturally and Linguistically Appropriate Services (CLAS) in Health Care. Executive Summary

    (2001)
  • The Medicare Advantage Organization National QAPI Project for 2003. Centers for Medicare and Medicaid Services....
  • Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care

    Unequal Treatment: Confronting Racial and Ethnic Disparities in Care

    (2002)
  • Cited by (424)

    • Development of a complex intervention (safe and secure) to support non-western migrant patients with palliative care needs and their families

      2023, European Journal of Oncology Nursing
      Citation Excerpt :

      Based on findings from the review, interviews and workshops, a patient-centred cultural competency training for healthcare professionals was designed. Evidence showed that it has the possiblity to improve the quality of healthcare for all patients by satisfying the needs of migrants and other disadvantaged groups, whose needs and preferences are often overshadowed by those of the majority (Saha et al., 2008). A core component of cultural competency is communication, which is often challenged in a cross-cultural clinical encounter by differences in language, health beliefs, concepts of illness, and role expectations, e.g., an apparent preference for an authoritarian approach or desire for a family-centred decision-making model (Suurmond and Seeleman, 2006; de Graaff et al., 2012).

    View all citing articles on Scopus

    Financial support: This study was supported by The Commonwealth Fund, a New York City-based private, independent foundation. Dr. Saha was supported by an Advanced Research Career Development Award from the Health Services Research and Development Service of the Department of Veterans Affairs. Drs. Saha and Beach were supported by Generalist Physician Faculty Scholar Awards from the Robert Wood Johnson Foundation. Dr. Cooper was supported by the National Heart Lung and Blood Institute (grant #K24HL083113). The views expressed in this paper are those of the authors and not necessarily those of The Commonwealth Fund, the Department of Veterans Affairs, the National Institutes of Health or the Robert Wood Johnson Foundation.

    View full text