A project that I recently led to characterize outcomes among patients who receive outpatient parenteral antibiotic therapy (OPAT) revealed racial disparities, and our study team is committed to elucidating the mechanisms driving these disparities. We seek to characterize deficiencies in our hospital’s patient-centered care dimensions and map those deficiencies to social determinants of health to better understand the specific ways in which vulnerable patient populations are at risk for sub-optimal patient-centered care. Using OPAT care - a scenario in which we have previously observed racial disparities in clinical outcomes – as a test case, we also seek to quantify the association between patient-assessment patient-centered care and clinical outcomes.
As an infectious diseases provider and medical director for infection prevention and control, my decade-long scholarly interest has been in the unintentional harms of medical care, including hospital-acquired conditions, (HACs). A topic that I have recently become passionate about involves data describing how minoritized patients are disproportionately represented among patients that experience HACs. I believe that inequities in HACs exacerbate the corrosive disadvantage our health system imposes on minoritized groups and contributes to disparities in other health indicators.
When my study team identified racial disparities in the clinical outcomes of outpatient parenteral antibiotic therapy (OPAT) recipients, we turned our attention to identifying the mechanisms for these disparities. We hypothesize that social determinants of health are rooted in deficiencies of patient-centered care in three key dimensions: interpersonal relationships, clinical care provision, and health system structure. Further, we hypothesize that patient-affiliated race within the current US social and community context is a determinant of OPAT-related outcomes through an association with the dimensions of patient-centered care. By engaging in work that seeks to better understand the discrete ways in which patient-centered care and social determinants of health intersect, we hope to identify opportunities for enhancing patient-centered care for communities whose non-medical conditions needlessly influence health outcomes.