title: Characteristics of families that complain following pediatric emergency visits.
abstract: OBJECTIVE
  The voicing of unsolicited observations by patients and families is a form of participation in the health care system. We investigated whether visits by patients of different race/ethnicities were equally represented in unsolicited complaints filed with a medical center's Office of Patient Affairs (OPA) regarding pediatric emergency visits.
  
  
  METHODS
  We conducted a population-based retrospective study, including pediatric emergency visits, at a large academic medical center between January 1999 and December 2002. We identified complaints to the OPA and conducted bivariate and multivariable analyses to determine whether patient race/ethnicity was associated with filing a complaint.
  
  
  RESULTS
  Among 105 322 total visits, the overall complaint rate was 1.22/1000 visits. Visits by white children had a complaint rate of 1.78/1000 visits compared with 0.37/1000 visits by African American children (P < .001). In multivariable analysis, visits by African American children remained less likely to be associated with a complaint to the OPA compared with visits by white children (adjusted odds ratio 0.30, 95% CI 0.17-0.55) after controlling for factors such as payer status.
  
  
  CONCLUSIONS
  Emergency-department visits by African American children were less likely to be associated with a complaint than visits by white children. Programs that use complaints in service recovery, quality assurance, and risk management efforts may unintentionally exclude segments of the patient population served by the institution.
authors.affiliation: Vanderbilt University School of Medicine, Department of Pediatrics, Nashville, TN 37232-8555, USA. kecia.carroll@vanderbilt.edu
authors.forename: Kecia N
authors.initials: KN
authors.lastname: Carroll
authors.forename: William O
authors.initials: WO
authors.lastname: Cooper
authors.forename: Jennifer U
authors.initials: JU
authors.lastname: Blackford
authors.forename: Gerald B
authors.initials: GB
authors.lastname: Hickson
mesh_terms: D000293:Adolescent; D001741:Black or African American; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005191:Family Characteristics / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D008297:Male; D011787:Quality of Health Care; D012189:Retrospective Studies; D044465:White People