Nurses’ Patient-Centeredness and Perceptions of Care among Medicaid Patients in Hospital Obstetrical Units

Objective . This study examined to what degree patient-centeredness—measured as an underlying ability of obstetrical nurses—influenced Medicaid patients' satisfaction with care in hospital obstetrical units. Design . Multigroup structural equation modeling design, using three cross-sectional random samples ( n = 300 each) from the 2003 Press Ganey National Inpatient Database. Setting . Self-administered mail surveys. Participants . 900 Medicaid recipients recently discharged from inpatient hospital obstetrical units across the United States. Methods . Multigroup structural equation modeling was used to test the goodness of fit between a hypothesized model based on the Primary Provider Theory and patients' ratings of nurses. Results . The model fitted the data well, was stable across three random samples, and was sustained when compared to a competing model. The patient-centeredness of nurses significantly influenced overall patient satisfaction and explained 66% of its variability. When nurses' patient-centeredness increased by one standard deviation, patients' satisfaction increased by 0.80 standard deviation. Conclusion . This study offers a novel approach to the measurement of the patient-centeredness of nurses and a paradigm for increasing it and its influence on Medicaid patients' satisfaction in hospital obstetrical units.