Despite increased emphasis on patient satisfaction as a quality measure in health care, little is known about the influence of race in parent-reported experience of care in pediatrics. This study evaluates the association of race with patient satisfaction scores in an inpatient pediatric tertiary care hospital in one year. Risk-adjusted multivariable logistic regression was performed to evaluate the association of minority race with the likelihood to provide a top-box (=5) satisfaction score for 38 individual questions across 8 domains. Of the 904 participants, 269 (29.8%) identified as belonging to a minority race. Parents of minority children reported 30% to 50% lower satisfaction across questions related to well-established themes of interpersonal communication and cultural competency. Overall, minorities also reported lower satisfaction for the domain of nursing care (odds ratio 0.7, P = .016). These findings suggest a need for training and interventions to improve communication and mitigate disparities in how minority patients and their families perceive pediatric care.
Institute of Medicine Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press; 2001.
2.
NelsonARSmedleyBDStithAY. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press; 2002.
3.
SchmockerRKCherney StaffordLMSiyABLeversonGEWinslowER. Understanding the determinants of patient satisfaction with surgical care using the Consumer Assessment of Healthcare Providers and Systems surgical care survey (S-CAHPS). Surgery. 2015;158:1724-1733.
4.
ZgierskaARabagoDMillerMM. Impact of patient satisfaction ratings on physicians and clinical care. Patient Prefer Adherence. 2014;8:437-446.
5.
CleverSLJinLLevinsonWMeltzerDO. Does doctor-patient communication affect patient satisfaction with hospital care? Results of an analysis with a novel instrumental variable. Health Serv Res. 2008;43(5 pt 1):1505-1519.
6.
WadePBernsteinBL. Culture sensitivity training and counselor’s race: effects on black female clients’ perceptions and attrition. J Couns Psychol. 1991;38:9-15.
7.
ZolnierekKBDiMatteoMR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care. 2009;47:826-834.
8.
SafranDGMontgomeryJEChangHMurphyJRogersWH. Switching doctors: predictors of voluntary disenrollment from a primary physician’s practice. J Fam Pract. 2001;50:130-136.
9.
GlickmanSWBouldingWManaryM. Patient satisfaction and its relationship with clinical quality and inpatient mortality in acute myocardial infarction. Circ Cardiovasc Qual Outcomes. 2010;3:188-195.
Patient Protection and Affordable Care Act. Public Law. 2010:111-148.
12.
GoldsteinEElliottMNLehrmanWGHambarsoomianKGiordanoLA. Racial/ethnic differences in patients’ perceptions of inpatient care using the HCAHPS survey. Med Care Res Rev. 2010;67:74-92.
13.
BossEFThompsonRE. Patient satisfaction in otolaryngology: can academic institutions compete?Laryngoscope. 2012;122:1000-1009.
14.
BossEFThompsonRE. Patient experience in outpatient pediatric otolaryngology. Laryngoscope. 2012;122:2304-2310.
15.
CollinsTCClarkJAPetersenLAKressinNR. Racial differences in how patients perceive physician communication regarding cardiac testing. Med Care. 2002;40:I-27-I-34.
16.
CooperLABeachMCJohnsonRLInuiTS. Delving below the surface. J Gen Intern Med. 2006;21(suppl 1):S21-S27.
17.
CooperLARoterDLCarsonKA. The associations of clinicians’ implicit attitudes about race with medical visit communication and patient ratings of interpersonal care. Am J Public Health. 2012;102:979-987.
18.
Weech-MaldonadoRMoralesLSElliottMSpritzerKMarshallGHaysRD. Race/ethnicity, language, and patients’ assessments of care in Medicaid managed care. Health Serv Res. 2003;38:789-808.
19.
ToomeySLZaslavskyAMElliottMN. The development of a pediatric inpatient experience of care measure: Child HCAHPS®. Pediatrics. 2015;136:360-369.
20.
Press Ganey Associates, Inc, ed. Medical Practice Survey. South Bend, IN: Press Ganey Associates, Inc; 2004.
RogersFHorstMToT. Factors associated with patient satisfaction scores for physician care in trauma patients. J Trauma Acute Care Surg. 2013;75:110-115.
26.
NiemanCLBenkeJRBossEF. Does race/ethnicity or socioeconomic status influence patient satisfaction in pediatric surgical care?Otolaryngol Head Neck Surg. 2015;153:620-628.
27.
Weech-MaldonadoRCarleAWeidmerBHurtadoMNgo-MetzgerQHaysRD. The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Cultural Competence (CC) item set. Med Care. 2012;50(9 suppl 2):S22-S31.
28.
Weech-MaldonadoRMoralesLSSpritzerKElliottMHaysRD. Racial and ethnic differences in parents’ assessments of pediatric care in Medicaid managed care. Health Serv Res. 2001;36:575-594.
29.
NiemanCLBenkeJRIshmanSLSmithDFBossEF. Whose experience is measured? A pilot study of patient satisfaction demographics in pediatric otolaryngology. Laryngoscope. 2014;124:290-294.
30.
ElliottMNKanouseDEEdwardsCAHilborneLH. Components of care vary in importance for overall patient-reported experience by type of hospitalization. Med Care. 2009;47:842-849.
31.
BlairIVSteinerJFFaircloughDL. Clinicians’ implicit ethnic/racial bias and perceptions of care among black and Latino patients. Ann Fam Med. 2013;11:43-52.
32.
BeachMCSugarmanJJohnsonRLArbelaezJJDugganPSCooperLA. Do patients treated with dignity report higher satisfaction, adherence, and receipt of preventive care?Ann Fam Med. 2005;3:331-338.
33.
JohnsonRLRoterDPoweNRCooperLA. Patient race/ethnicity and quality of patient-physician communication during medical visits. Am J Public Health. 2004;94:2084-2090.
34.
PennerLADovidioJFWestTV. Aversive racism and medical interactions with black patients: a field study. J Exp Soc Psychol. 2010;46:436-440.
35.
PurvisJM. The challenge of communicating with pediatric patients. AAOS Now. 2009;3(2).
36.
ElliottMNBeckettMKChongKHambarsoomiansKHaysRD. How do proxy responses and proxy-assisted responses differ from what Medicare beneficiaries might have reported about their health care?Health Serv Res. 2008;43:833-848.
37.
Maine Quality Forum. Patient Experience Survey Guidelines, 2014: A Guide for Qualified Vendors and Participating Practices. Dirigo Health Agency’s Maine Quality Forum; 2014.
38.
FongwaMNSetodjiCMPazSHMoralesLSSteersWHaysRD. Readability and missing data rates in CAHPS 2.0 Medicare survey in African American and white Medicare respondents. Health Outcomes Res Med. 2010;1:e39-e49.
39.
ZaslavskyAMZaborskiLBClearyPD. Factors affecting response rates to the Consumer Assessment of Health Plans Study survey. Med Care. 2002;40:485-499.
