The association between care experiences and parent ratings of care for different racial, ethnic, and language groups in a Medicaid population

Health Serv Res. 2011 Jun;46(3):821-39. doi: 10.1111/j.1475-6773.2010.01234.x. Epub 2011 Jan 28.


Objective: To examine the association between care experiences and parent ratings of care within racial/ethnic/language subgroups.

Data source: National Consumer Assessment of Healthcare Providers and Systems Benchmarking Database 3.0 (2003-2006). Sample Characteristics. 111,139 parents of minor Medicaid managed care enrollees.

Study design: Cross-sectional observational study predicting "poor" (0-5 on 0-10 scale) parent ratings of personal doctor, specialist, health care, and health plan from care experiences for different parent race/ethnicity/language subgroups (Latino/Spanish, Latino/English, white, and black).

Principal findings: Care experiences had similar associations with the probability of poor parent ratings of care across the four racial/ethnic/language subgroups (p>.20). A one standard deviation improvement in the doctor communication care experience was associated with about half the frequency of poor ratings of care for personal doctor and health care in all subgroups (p<.05). Sensitivity analysis of individual communication items found that failure to provide explanations to children predicted poor ratings of care only among whites, who also weighed the length of physician interaction more heavily than other subgroups.

Conclusions: Communication-based interventions may improve experiences and ratings of care for all subgroups, although implementation of these interventions may need to consider preferences associated with race, ethnicity, and language.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • African Americans / statistics & numerical data
  • Benchmarking*
  • Child
  • Child, Preschool
  • Communication Barriers
  • Female
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Managed Care Programs*
  • Medicaid* / statistics & numerical data
  • Middle Aged
  • Multilingualism
  • Multivariate Analysis
  • Parents*
  • Patient Satisfaction / ethnology*
  • Pediatrics
  • Physician-Patient Relations
  • Retrospective Studies
  • United States
  • Whites / statistics & numerical data