The Role and Relationship of Cultural Competence and Patient-Centeredness in Health Care Quality

Mary Catherine Beach, Somnath Saha, Lisa A. Cooper | The Commonwealth Fund | 1 October 2006


In recent years, patient-centeredness and cultural competence have been promoted as integral components in improving health care quality. Although these two approaches to health care delivery have grown out of separate traditions—each with its own focus—they have many similarities. This paper presents and compares models of patient-centeredness and cultural competence, and discusses their implications for improving health care quality at the level of interpersonal care and at the health-system level.

Patient-centeredness originated in the late 1960s as a way of characterizing how physicians should interact and communicate with patients on a more personal level. Core features include: understanding the patient as a unique person, exploring the patient’s experience of illness, finding common ground regarding treatment through shared decision-making, and an emphasis on building the doctor–patient relationship. In essence, patient-centeredness involves perceiving and evaluating health care from the patient’s perspective and then adapting care to meet the needs and expectations of patients.

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