 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
David M. Mosen, PhD1, Matthew J. Carlson, PhD1, and Cindy Fessler, BA2. (1) Department of Public Health and Preventive Medicine, CareOregon and Oregon Health & Science University, 522 SW Fifth Ave, Suite 200, Portland, OR 97204, (503) 416-1482, mosend@careoregon.org, (2) Research and Evaluation, CareOregon, 522 SW 5th Avenue, Suite 200, Portland, OR 97236
Background: Few studies have compared ratings of provider communication among Spanish-speaking and English-speaking parents in a pediatric Managed Medicaid Population. Even fewer have attempted to explain language differences in ratings. Differences in ratings of provider communication by language may be driven by need for interpretive services.
Methods: Using the Consumer Assessment of Health Plans Survey-Child Survey (CAHPS), we compared ratings of provider communication among 3 groups of parents enrolled in a Managed Medicaid Health Plan: 1) English-speakers (N = 358), 2) Spanish-speakers with no need of interpretive services (N = 91) and 3) Spanish speakers who needed interpretive services (n = 121). Parents were asked to rate how well their providers 1) listened carefully, 2) explained things 3) respected comments and concerns, and 4) spent enough time during medical encounters. Chi-square analysis was used to examine the bivariate association between language, need for interpretive services and ratings of health care providers. Multivariate logistic regression was used to compare the ratings of each of the three groups while controlling for parent’s age, parent’s gender, parent’s educational attainment, and child’s health status.
Results: In bivariate analyses, Spanish-speaking parents rated their providers significantly lower for explained things well (61.7% vs 73.5%, p = .03) and spent enough time (32.5% vs 58.6%, p < .001). Only one item, spent enough time, remained significant in multivariable analysis. Spanish-speaking parents in need of interpretive services were less likely to report that providers spent enough time with their children (O.R. = 0.31 95% C.I. = 0.18-0.53) compared to English-speaking parents. There was no significant difference found between Spanish speaking parents with no need of interpretive services compared to English-speaking parents.
Conclusions: There were few differences between language groups on ratings of provider communication. Language differences in satisfaction with provider communication were explained by need for interpretive services; suggesting that Spanish-speaking parents in need of interpretive services have different experiences of care than those who do not. No other differences in ratings of provider communication were found after controlling for case mix adjustors. Further research is needed that examines how variation in delivery of interpretive services impacts the quality of health care service delivery.
Learning Objectives:
Keywords: Pediatrics, Patient Satisfaction
Presenting author's disclosure statement: