Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109804

Gregory D. Stevens, PhD, MHS, Division of Community Health, Department of Family Medicine, USC Keck School of Medicine, 1000 S. Fremont Ave, Building A7, Rm 7411, Alhambra, CA 91803, 626-457-4049, gregorydstevens@yahoo.com and Ritesh I. Mistry, PhD, MPH, School of Public Health, University of California, Los Angeles, 1454 Armacost Ave., Los Angeles, CA 90025.

Context: Recent research among adults suggests that having a provider of the same race and ethnicity may enhance the quality of health care above and beyond just having a regular source of care. It is not known whether such relationships exist in pediatric care.

Objective: Identify the distribution and determinants of having a race/ethnicity concordant provider of well-child care, and examine if differences exist in the receipt of basic preventive services and family-centered care among those with concordant, discordant and no regular providers.

Design: Analysis of the 2000 National Survey of Early Childhood Health, a nationally-representative, cross-sectional telephone survey of parents of children ages 4-35 months (n=1,996).

Outcome Measures: Basic preventive services (BPS) and family-centered care (FCC)

Results: African-Americans and Latinos were more likely than whites to have no regular provider of well-child care (60.9% and 65.7%, vs. 50.6%) and less likely to have a concordant provider (9.8% and 5.7% vs. 38.5%) (p<.001). For Latinos, Spanish interview predicted having a concordant provider (OR=3.78, CI: 0.17-0.86) and receiving care in a health center/clinic was associated with having a concordant provider among whites (OR=3.45, CI: 1.86-6.39). Whites with concordant providers (vs. discordant) were more likely to say the provider was recommended to them (55.8% vs. 40.8%, p<.01). No differences in BPS or FCC were found between those with concordant and discordant providers for any group. Children with no regular provider were less likely to have excellent BPS among whites (27.1% vs. 37.2%, p<.05) and lower FCC in 1 (Latinos, whites) or 3 domains (African-Americans).

Conclusion: Despite racial/ethnic differences in the likelihood of having a regular concordant provider of well-child care, no differences were found in BPS or FCC associated with discordance. Differences were found in BPS (whites) and FCC (all) for those with no regular provider. Efforts to improve these aspects of well-child care should focus less on linking children with a race/ethnicity concordant provider, and more on social, cultural, and linguistic factors that impact having any regular provider.

Learning Objectives:

• To understand whether having a regular provider of well-child care that is the same race/ethnicity as the family is associated with improved basic pediatric preventive services above and beyond having any regular source of care

Keywords: Pediatrics, Vulnerable Populations

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation