Posts Tagged ‘demographics’

Cultural competence in healthcare and beyond

Monday, March 29th, 2004

Is your workers comp provider network culturally competent? If not, you may fostering needless disability. Georgetown University’s Center on an Aging Society has an excellent article on the issue of cultural competence in healthcare, and defines the concept as “the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients.”

The article addresses the specialized medical needs that the changing demographics demand, both for reasons of language and other cultural and socio-economic factors. It makes the case that positive outcomes require that physicians and other providers develop cultural competence in service delivery. Barring this competence, minorities are more likely to be dissatisfied with care.

If the providers, organizations, and systems are not working together to provide culturally competent care, patients are at higher risk of having negative health consequences, receiving poor quality care, or being dissatisfied with their care. African Americans and other ethnic minorities report less partnership with physicians, less participation in medical decisions, and lower levels of satisfaction with care. The quality of patient-physician interactions is lower among non-White patients, particularly Latinos and Asian Americans. Lower quality patient-physician interactions are associated with lower overall satisfaction with health care.

In workers comp, poor quality care and dissatisfaction hinder recovery and may well prolong disability. Dissatisfaction often also turns into lawsuits that might have been prevented. The issue of cultural competence has relevance to workers compensation in terms of health-care services delivered by workers compensation provider networks, but also in other aspects of prevention and claims management as well. We’ve previously discussed some of the challenges posed by an increasingly multilingual workforce, as well as the fact that some immigrant workers are at high risk of injuries or death.

The article suggests the following strategies for improving the patient-provider interaction and institutionalizing changes in the health care system:
1. Provide interpreter services
2. Recruit and retain minority staff
3. Provide training to increase cultural awareness, knowledge, and skills
4. Coordinate with traditional healers
5. Use community health workers
6. Incorporate culture-specific attitudes and values into health promotion tools
7. Include family and community members in health care decision making
8. Locate clinics in geographic areas that are easily accessible for certain populations
9. Expand hours of operation
10. Provide linguistic competency that extends beyond the clinical encounter to the appointment desk, advice lines, medical billing, and other written materials

This list might be a useful adjunct to an employer’s current gating issues when screening medical providers for a workers comp program. It also provides a checklist of considerations for loss control, risk management, and claims staff as well.