258942 Race-ethnic differentials in guardian rating of their child healthcare providers

Tuesday, October 30, 2012

Shyam Misra, MD, PhD , Health and Human Services (HHS), Agency for Healthcare Research and Quality, Rockville, MD
Edwin Lomotan, MD , Department of Health and Human Services, Agency for Healthcare Research and Quality, Rockville
Francis Chesley, MD , Office of Extramural Research, Education, and Priority Populations, Agency for Healthcare Research and Quality, Rockville, MD
AHRQ's Consumer Assessment of Healthcare Providers and Systems (CAHPS) data maintained in Medical Expenditure Panel Survey (MEPS), a nationally representative database, allows assessment of care quality as perceived by the guardians of children. This study analyzed annual consolidated MEPS data from 2005 to 2008 using step-up multivariable logistic regression to determine the effects of perceived provider responsiveness and respondent race/ethnicity on provider rating after adjusting for other associated factors-health, access, travel, clinic timings, type of facility and other demographic covariates. Around 5-7% of guardians of all communities consider their children less healthy than other children. Although 31% of Asian guardians felt their children got sick easily, 82% reported that their children never got ill compared to 75 and 79% of Black and White Americans respectively. Asians and Black guardians adjusted to other factors were found to give a lower provider rating. Higher provider rating was significantly associated with respondents across all race/ethnicity who perceived they were given enough time and respect. We also discuss the influence of timely appointment, preventive and promotive services on patient satisfaction.

Patient satisfaction is associated with provider communication skills and Asian American guardians are more likely to be dissatisfied with their providers. What matters is communication skills regardless of provider race/ethnicity and is largely demonstrated by time shared with patients. Since patient satisfaction is the first step towards patient engagement, healthcare providers training curriculum must include culture competency. A diverse workforce without cultural competency and communication skills will not reduce the healthcare quality gap.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Provision of health care to the public
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
To demonstrate and discuss the predictive value of child provider attributes on healthcare rating/guardian satisfaction by race/ethnicity.

Keywords: Patient Satisfaction, Asian Americans

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am trained as a physician with residency in Preventive and Social Medicine and with a PhD in Infectious and Tropical Diseases. I have been involved in Public Health and research for nearly two decades. I have multiple publication to my credit using both primary and secondary data. Presently engaged as Special Expert for intramural research in Agency for Healthcare Research and Quality using in-house database MEPS and other program activities associated with minority healthcare.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.