Racial, Ethnic, and Language Inequities in Ambulatory Pediatrics Patient Family Experience.

IF 3 3区 医学 Q1 PEDIATRICS
Margaret N Jones, Michael Ponti-Zins, Melinda MacDougall, Shelley Ehrlich, Ndidi Unaka, Samuel Hanke, Jareen Meinzen-Derr, Mary C Burkhardt, Alexandra Corley, Ryan Adcock, Sana Amanullah, Jamilah Hackworth, Kristen Copeland, Jessica A Kahn, Andrew F Beck
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引用次数: 0

Abstract

Objective: To determine the association of patient race, patient-provider racial congruence, patient ethnicity, and family primary language with patient family experience (PFE) survey responses.

Methods: Cross-sectional review of PFE survey responses from all ambulatory medical encounters at a large, urban children's hospital system June 1, 2020-May 31, 2022. Exposures were patient race, patient-provider racial congruence, patient ethnicity, and family primary language. We adjusted analyses for neighborhood-level socioeconomic deprivation, patient sex and age, encounter specialty, and location of care. Outcomes were PFE survey scores for five questions focused on overall experience, respect, and safety; categorized using industry standard metric of presence of a "top-box" score, defined as a nine or 10 for questions on an 11-point scale or as four on a four-point scale.

Results: We included 89,175 surveys (15.6% response rate). The odds of having optimal, "top-box" responses for several assessed questions were lower for patients identified as Asian (eg, adjusted odds ratio [OR] 0.46; 95% confidence interval [CI] 0.40, 0.52) or Black (eg, OR 0.65; CI 0.60, 0.70) compared to White, and for Hispanic (eg, OR 0.84; CI 0.72, 0.97) compared to non-Hispanic. Similarly, the odds of having "top-box" scores were lower for Spanish-primary-language (eg, OR 0.38; CI 0.30, 0.48) compared to English-primary-language patients. Patient-provider racial congruence had higher odds of "top-box" responses for two of five assessed questions (eg, OR 1.18; CI 1.04, 1.35).

Conclusions: We found previously unreported inequities in ambulatory pediatric PFE outcomes, with worse experiences reported by Asian, Black, Hispanic, and Spanish-language patients.

门诊儿科患者家庭体验中的种族、民族和语言不平等。
目的确定患者种族、患者-医疗服务提供者种族一致性、患者民族和家庭主要语言与患者家庭体验(PFE)调查回复的关联:方法:对一家大型城市儿童医院系统 2020 年 6 月 1 日至 2022 年 5 月 31 日所有门诊医疗就诊的 PFE 调查回复进行横断面回顾。暴露因素包括患者种族、患者与医护人员种族一致性、患者种族和家庭主要语言。我们对邻里社会经济贫困程度、患者性别和年龄、就诊专科和就诊地点进行了调整分析。结果是针对 5 个问题的 PFE 调查得分,这些问题集中在总体体验、尊重和安全方面;采用行业标准的 "最高箱 "得分标准进行分类,在 11 分制的问题上定义为 9 分或 10 分,在 4 分制的问题上定义为 4 分:我们共收集了 89 175 份调查问卷(回复率为 15.6%)。与白人相比,亚裔(如调整后的赔率[OR]0.46;95% 置信区间[CI]0.40, 0.52)或黑人(如赔率 0.65;CI 0.60, 0.70)患者对几个评估问题做出最佳 "顶格 "回答的几率较低;与非西班牙裔相比,西班牙裔患者做出最佳 "顶格 "回答的几率较低(如赔率 0.84;CI 0.72, 0.97)。同样,与以英语为母语的患者相比,以西班牙语为母语的患者获得 "顶级箱 "评分的几率较低(如 OR 0.38;CI 0.30,0.48)。在 5 个评估问题中,有 2 个问题的 "顶格 "回答中,患者与医疗服务提供者种族一致的几率更高(例如,OR 1.18;CI 1.04,1.35):我们发现了以前未曾报道过的门诊儿科急诊急症治疗结果的不公平现象,亚裔、黑人、西班牙裔和西班牙语患者的治疗体验较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Academic Pediatrics
Academic Pediatrics PEDIATRICS-
CiteScore
4.60
自引率
12.90%
发文量
300
审稿时长
60 days
期刊介绍: Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.
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