title: Does Race/Ethnicity or Socioeconomic Status Influence Patient Satisfaction in Pediatric Surgical Care?
abstract: OBJECTIVE
  To evaluate patient satisfaction in outpatient pediatric surgical care and assess differences in scores by race/ethnicity and socioeconomic status (SES).
  
  
  METHODS
  Observational, cross-sectional analysis.
  
  
  METHODS
  Outpatient pediatric surgical specialty clinics at a tertiary academic center.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Nieman
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Benke
authors.affiliation: 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 erudnic2@jhmi.edu.
authors.forename: Emily F
authors.initials: EF
authors.lastname: Boss
mesh_terms: D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017060:Patient Satisfaction; D044469:Racial Groups; D012923:Social Class; D013514:Surgical Procedures, Operative; D011795:Surveys and Questionnaires
keywords: family-centered care; health disparities; patient satisfaction; patient-centered care; pediatric ambulatory surgery; pediatric surgical specialties