title: Whose experience is measured? A pilot study of patient satisfaction demographics in pediatric otolaryngology.
abstract: OBJECTIVE
  Despite a national emphasis on patient-centered care and cultural competency, minority and low-income children continue to experience disparities in health care quality. Patient satisfaction scores are a core quality indicator. The objective of this study was to evaluate race and insurance-related disparities in parent participation with pediatric otolaryngology satisfaction surveys.
  
  
  METHODS
  Observational analysis of patient satisfaction survey respondents from a tertiary pediatric otolaryngology division.
  
  
  METHODS
  Demographics of survey respondents (Press Ganey Medical Practice Survey©) between January and July 2012 were compared to a clinic comparison group using t test and chi-square analyses. Multivariate logistic regression analyses were performed to assess likelihood to complete a survey based on race or insurance status.
  
  
  RESULTS
  A total of 130 survey respondents were compared to 1,251 patients in the comparison group. The mean patient age for which the parent survey was completed was 5.7 years (6.1 years for the comparison group, P = 0.18); 59.2% of children were ≤ 5 years old. Relative to the comparison group, survey respondents were more often white (77.7% vs. 58.1%; P <0.001) and privately insured (84.6% vs. 60.8%; P <0.001). Similarly, after controlling for confounding variables, parents of children who were white (OR 1.8, 95% CI 1.13-2.78, P = 0.013) or privately insured (OR 2.9, 95% CI 1.74-4.85, P <0.001) were most likely to complete a survey.
  
  
  CONCLUSIONS
  Methods to evaluate satisfaction did not capture the racial or socioeconomic patient distribution within this pediatric division. These findings challenge the validity of applying patient satisfaction scores, as currently measured, to indicate health care quality. Future efforts to measure and improve patient experience should be inclusive of a culturally diverse population.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Nieman
authors.forename: James R
authors.initials: JR
authors.lastname: Benke
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Ishman
authors.forename: David F
authors.initials: DF
authors.lastname: Smith
authors.forename: Emily F
authors.initials: EF
authors.lastname: Boss
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010036:Otolaryngology; D010038:Otorhinolaryngologic Diseases / Q000628:therapy*; D017060:Patient Satisfaction; D010372:Pediatrics; D010865:Pilot Projects; D011795:Surveys and Questionnaires
keywords: Patient satisfaction; family-centered care; health disparities; medical assistance; minority health care; patient experience; patient-centered care; pediatric ambulatory surgery