Evaluating community pediatricians' performance by measuring parents' experiences: A tool for policymakers for assessing community pediatric care

Background: High quality community pediatric care is a cornerstone of efforts to improve health outcomes, control healthcare spending and improve access to care. Parents' perceptions of their experiences with their child's pediatrician are important indicators for evaluating pediatric primary care quality.

Objective: To evaluate parents' perceptions of their child's community pediatrician.

Methods: Telephone interviews with a random national sample of parents of children (n=486) treated by pediatricians in Israel's two largest health plans. Parents were asked to assess their pediatrician's performance based on six key components of primary care on which parents are able to report: continuity, access, contextual knowledge, communication, comprehensiveness and coordination.

Results: Most parents (67.2%) reported high levels of satisfaction with their child's pediatrician. In 10 out of 16 areas of pediatric care that were evaluated, over 75% of parents expressed a high degree of satisfaction with their community pediatrician. However in areas requiring more initiative from the pediatrician (e.g. discussing behavioral issues), as opposed to the traditional management of common problems, most parents expressed a lesser degree of satisfaction (on average 35.7% of parents expressed a high degree of satisfaction). In a multivariable model, the only variables significantly associated with high satisfaction were: ongoing treatment with the same pediatrician, and 2-4 children in the family. Academic education was found to predict a lower level of satisfaction.

Conclusion: Policymakers should consider ways of improving pediatricians' performance in areas with low satisfaction in order to assure high quality comprehensive pediatric care in the community.