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
{"title":"Racial, Ethnic, and Language Inequities in Ambulatory Pediatrics Patient Family Experience.","authors":"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","doi":"10.1016/j.acap.2024.08.015","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine the association of patient race, patient-provider racial congruence, patient ethnicity, and family primary language with patient family experience (PFE) survey responses.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>We found previously unreported inequities in ambulatory pediatric PFE outcomes, with worse experiences reported by Asian, Black, Hispanic, and Spanish-language patients.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.acap.2024.08.015","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
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.
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.