title: Identifying elements of patient-centered care in underserved populations: a qualitative study of patient perspectives.
abstract: Patient-centered care is an important goal in the delivery of healthcare. However, many patients do not engage in preventive medical care. In this pilot study, we conducted twenty in depth, semi-structured qualitative interviews at the University of Illinois at Chicago Health Sciences campus in a four month time frame. Many patients were underserved and underinsured, and we wanted to understand their experiences in the healthcare system. Using content analysis, several themes emerged from the interview data. Participants discussed the need for empathy and rapport with their providers. They identified provider behaviors that fostered a positive clinical relationship, including step-by step explanations of procedures, attention to body language and clinic atmosphere, and appropriate time management. Participants identified cost as the most common barrier to engaging in preventive care and discussed children and social support as motivating factors. A long-term relationship with a provider was an important motivator for preventive care, suggesting that the therapeutic alliance was essential to many patients. Conversely, many participants discussed a sense of dehumanization in the healthcare system, reporting that their life circumstances were overlooked, or that they were judged based on insurance status or ethnicity. We discuss implications for provider training and healthcare delivery, including the importance of patient-centered medical homes.
authors.affiliation: Department of Pediatric Dentistry, University of Illinois at Chicago, Chicago, IL, United States of America.
authors.forename: Sheela
authors.initials: S
authors.lastname: Raja
authors.affiliation: Department of Family Medicine, University of Illinois at Chicago, Chicago, IL, United States of America.
authors.forename: Memoona
authors.initials: M
authors.lastname: Hasnain
authors.affiliation: University of Illinois at Chicago, Chicago, IL, United States of America.
authors.forename: Tracy
authors.initials: T
authors.lastname: Vadakumchery
authors.affiliation: University of Illinois at Chicago, Chicago, IL, United States of America.
authors.forename: Judy
authors.initials: J
authors.lastname: Hamad
authors.affiliation: University of Illinois at Chicago, Chicago, IL, United States of America.
authors.forename: Raveena
authors.initials: R
authors.lastname: Shah
authors.affiliation: Office on Women's Health, Region V, U.S. Department of Health and Human Services, Chicago, IL, United States of America.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hoersch
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D018802:Patient-Centered Care