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

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.