Challenging a Fundamental Proposition of Patient-Centeredness

Stephen Aragon; Mak Khojasteh; Montrale Boykin; Breanne Crumpton; Laura McGuinn; Sabina Gesell

Challenging a Fundamental Proposition of Patient-Centeredness

J Best Pract Health Prof Divers. 2020 Fall;13(2):94-119.

Authors

Stephen Aragon¹, Mak Khojasteh², Montrale Boykin¹, Breanne Crumpton³, Laura McGuinn⁴, Sabina Gesell⁵

Affiliations

¹ Department of Healthcare Management, Winston-Salem State University, Winston-Salem, North Carolina.
² Department of Marketing and Management, Winston-Salem State University, Winston-Salem, North Carolina.
³ C.G. O'Kelly Library, Winston-Salem State University, Winston-Salem, North Carolina.
⁴ Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
⁵ Departments of Public Health Sciences and the Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, North Carolina.

PMID: 35310827
PMCID: PMC8929671

Abstract

This investigation challenged the proposition that physician patient-centeredness influences patients' experience-of-care (PEC). A theory-driven, three-factor, multigroup structural equation modeling design, using asymptotic-distribution-free and bootstrap estimation, with two national random and 5,000 bootstrap samples challenged the proposition's plausibility, measurement invariance, replicability, robustness against a competing model, and coherence with theory. The model fit [χ²(39) = 28, p =.900, RMSEA = .001, p = 1.00, CFI = 1.00], explaining 81 percent of PEC's variance; the proposition was invariant across samples, held against the competing model [χ²Δ(7) = 7.82, p = .97]; cross-validated against estimates from the 5,000 bootstrap samples; and agreed with theory. One standardized increase in patient-centeredness increased PEC, likelihood of recommending, and care ratings by .807, .765, and .771. Results converged in sustaining the plausibility of the proposition.

Keywords: Experience-of-Care; Multigroup Structural Equation Modeling; Patient-Centeredness; Quality Measurement; The Primary Provider Theory; Value-Based Care.

Abstract

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