Exploring the efficacy of cultural competence on service quality of outpatient care in Australia

Globalisation and the growth in migration has shaped many multicultural societies where intercultural service encounters in the health care context have become commonplace. Today's health professionals encounter patients from different cultural backgrounds who need care from providers who are both knowledgeable in their work and aware of the role that culture plays in patient treatment. However, insufficient cultural competence among the health workforce has been widely stated as one of the factors contributing to the health disparities and misunderstandings that lead to medical errors among ethnically diverse patients. Unfortunately, cultural competence preparation and training have not received enough attention in medical and education sectors. The scarcity of empirical evidence on the efficacy of cultural competence has hindered the promotion of this phenomenon in service sectors such as the health sector. Particularly, in Australia yet there has been no systematic evaluation of the potential health benefits of culturally competent services. To investigate the impact of cultural competence on health care quality, various aspects of service quality in the health care context should first be identified. However, in Australia factors that patients may consider important in assessing the quality of care remain somewhat unexplored. This study contributes to the research of service quality within an intercultural health care framework and explores whether providers' cultural competence impacts patients' ratings of the quality of health services. Using a mixed methodology this research a) examines the primary dimensions of service quality in the health care context; and b) explores the impact of patient-provider cultural distance and providers' cultural competence on the quality of health care. In the qualitative phase, 40 patients were interviewed to identify how they evaluate the quality of health care and assess providers' cultural competence. Then research models were developed based on the qualitative results. In the quantitative phase, data were collected through surveying 447 patients to test the proposed models. Contrary to many previous studies where the technical aspect of service in measuring patients' perceptions of care was excluded, the research findings suggest that both functional and technical aspects of service quality are significant in assessing the quality of outpatient care in the Australian health care sector. Moreover, empirical findings supported the significant impact of patient-provider cultural distance and providers' cultural competence on the quality of health services. This research illustrates an inclusive instrument of patient-perceived health care quality and delineates its relationship with cultural competence. The instrument would enable outpatient clinics to comprehend patients' feedback regarding the quality of health care received by them. This feedback could be used to examine clinics' performance, measure patient satisfaction and benchmark the performance against competitive medical settings.