Nieman Carrie L, Benke James R, Boss Emily F
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland, USA
Otolaryngol Head Neck Surg. 2015 Oct;153(4):620-8. doi: 10.1177/0194599815590592. Epub 2015 Jun 29.
To evaluate patient satisfaction in outpatient pediatric surgical care and assess differences in scores by race/ethnicity and socioeconomic status (SES).
Observational, cross-sectional analysis.
Outpatient pediatric surgical specialty clinics at a tertiary academic center.
Families of patients received a patient satisfaction survey following their initial care visit in 2012. Mean scores were calculated and compared by child race/ethnicity and insurance type, where insurance with medical assistance (MA) served as a proxy for low SES. Kruskal-Wallis tests were used to compare scores between groups. Surveys were dichotomized to low and high scorers, and multivariate logistic regression was used to calculate the likelihood of high satisfaction.
Of 527 surveys completed, 132 (25%) were for children with MA and 143 (27%) were for racial/ethnic minority children. The overall satisfaction score for all specialties was 84.8, which did not significantly differ by SES (P = .98) or minority status (P = .52). The survey item with the highest score in both SES groups was "degree to which provider talked with you using words you could understand" (overall mean 91.94, P = .23). Multivariate analysis showed that patient age, sex, race/ethnicity, insurance type, neighborhood SES, neighborhood diversity, or surgical department did not significantly influence satisfaction.
This is the first study to evaluate the relationship between SES and race/ethnicity with patient satisfaction in outpatient pediatric surgical specialty care. In this analysis, no disparities were identified in the patient experience by individual- or community-level factors. Although the survey methodologies may be limited, these findings suggest that provision of care in pediatric surgical specialties can be simultaneously equitable, culturally competent, and family centered.
评估儿科门诊手术护理中的患者满意度，并按种族/民族和社会经济地位（SES）评估得分差异。
观察性横断面分析。
一所三级学术中心的儿科门诊手术专科诊所。
患者家属在2012年首次就诊后接受了患者满意度调查。计算平均得分，并按儿童种族/民族和保险类型进行比较，其中有医疗补助（MA）的保险作为低SES的代表。采用Kruskal-Wallis检验比较组间得分。将调查分为低分者和高分者，采用多因素逻辑回归计算高满意度的可能性。
在完成的527份调查问卷中，132份（25%）是针对有MA的儿童，143份（27%）是针对种族/民族少数群体儿童。所有专科的总体满意度得分为84.8，SES（P = 0.98）或少数群体身份（P = 0.52）对此没有显著差异。两个SES组中得分最高的调查项目是“提供者使用您能理解的语言与您交谈的程度”（总体平均分为91.94，P = 0.23）。多因素分析表明，患者年龄、性别、种族/民族、保险类型、社区SES、社区多样性或外科科室对满意度没有显著影响。
这是第一项评估SES和种族/民族与儿科门诊手术专科护理患者满意度之间关系的研究。在本分析中，未发现个体或社区层面因素导致的患者体验差异。尽管调查方法可能存在局限性，但这些发现表明，儿科手术专科护理的提供可以同时做到公平、具有文化胜任力且以家庭为中心。
