title: Are poor families satisfied with the medical care their children receive?
abstract: While access to care has been shown to be worse for poor populations, few studies have examined the quality of care received by the poor vs the nonpoor. Furthermore, serious concerns have been raised about the impact of cost-containment efforts on the quality of health care for both the poor and nonpoor. The authors examine the interpersonal quality of medical care received by children from poor and nonpoor families by assessing parental satisfaction with physician-patient communication in a telephone survey of a nationally representative sample of households containing 2182 children and adolescents 17 years or younger. The majority of parents were satisfied with many aspects of their interactions with physicians. However, poor families were more likely to be not completely satisfied with the medical care their children received at their last health visit than nonpoor families (27% vs 12%, P less than .001). With regard to specific aspects of the physician-patient communication, poor families were more likely to be not satisfied with the physician's provision of information about the illness (40% vs 21%, P greater than .001); the physician's discussion of examination findings (21% vs 9%, P less than .001); and the opportunity provided by the physician to express their concerns (12% vs 6%, P less than .001). Logistic regression demonstrated that poor patients were approximately twice as likely to be not satisfied with the medical encounter and with various aspects of their communication with the physician. It is concluded that the parents of poor children are less satisfied with their care. Both policy and educational interventions may be needed to address this problem.
authors.affiliation: Cedars-Sinai Medical Center, Ahmanson Pediatric Center, Los Angeles, CA 90048.
authors.forename: D L
authors.initials: DL
authors.lastname: Wood
authors.forename: C
authors.initials: C
authors.lastname: Corey
authors.forename: H E
authors.initials: HE
authors.lastname: Freeman
authors.forename: M F
authors.initials: MF
authors.lastname: Shapiro
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003258:Consumer Behavior; D006801:Humans; D007223:Infant; D016015:Logistic Models; D011203:Poverty; D011368:Professional-Family Relations; D011787:Quality of Health Care