PM2097: Parents’ Perceptions of Medical Provider Encounters and Access to Care by Race/ethnicity from the National Survey of Children’s Health

Background: High quality primary care is important for promoting optimal child health. From birth to five years of age, a child should be seen by a primary care provider about fourteen times for health maintenance. Quality of parent-provider communication may vary by race, poverty, and/or education, which may be associated with inequitable health outcomes.

Methods: National Survey of Children’s Health database was used to examine perceived quality of care and whether they have a personal doctor or nurse in children 0 to 5 years old. A composite score was created, which measured their perception of whether the provider spent enough time, listened carefully, showed sensitivity, provided specific information, and made them feel like a partner. Scores ranged from 5-20 with 20 being the highest quality. Sturges’ rule was used to classify composite scores into five categories. Generalized ordinal logistic regression analysis was used to examine the association between composite score levels and education, poverty level, child having a personal doctor or nurse, and by racial group.

Results: The odds of being at a higher composite score level among Asian children was decreased by 31% compared to White children. It decreased by 28% among Hispanic children compared to White children and by 15% among non-Hispanic children with two or more races compared to White children. There was no significant difference in the comparison of Black to White children. The odds of being at higher composite score level among Family Poverty Ratio > 300% and Family Poverty Ratio 201-300% were 1.45 times and 1.23 times higher than those with Family Poverty Ratio < 100%, respectively. The odds of being at higher composite score level among children with personal doctor or nurse was 1.49 times higher than those with no personal doctor or nurse. All other variables failed to reach significance.

Conclusion: There are significant differences in the perceived quality of care based upon race, poverty ratio and children having a personal doctor or nurse. Further investigation is warranted to understand the specific reasons why the perceived quality of care is lower for these groups. Targeting care quality factors for specific groups can reduce inequity in health outcomes for children from birth to five years old.