PEDIATRICS Vol. 90 No. 1 July 1992, pp. 66-70
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Are Poor Families Satisfied With the Medical Care Their Children Receive?

David L. Wood MD, MPH1, Chris Corey MA2, Howard E. Freeman PhD2, and Martin F. Shapiro MD, PhD3

1 From the Cedars-Sinai Medical Center, Ahmanson Pediatric Center, Los Angeles, CA
2 From the Departments of Sociology, UCLA
3 From the Internal Medicine, UCLA

While access to care has been shown to be worse for poor populations, few studies have examined the quality of care received by the poor vs the nonpoor. Furthermore, serious concerns have been raised about the impact of cost-containment efforts on the quality of health care for both the poor and nonpoor. The authors examine the interpersonal quality of medical care received by children from poor and nonpoor families by assessing parental satisfaction with physician-patient communication in a telephone survey of a nationally representative sample of households containing 2182 children and adolescents 17 years or younger. The majority of parents were satisfied with many aspects of their interactions with physicians. However, poor families were more likely to be not completely satisfied with the medical care their children received at their last health visit than nonpoor families (27% vs 12%, P < .001). With regard to specific aspects of the physician-patient communication, poor families were more likely to be not satisfied with the physician's provision of information about the illness (40% vs 21%, P > .001); the physician's discussion of examination findings (21% vs 9%, P < .001); and the opportunity provided by the physician to express their concerns (12% vs 6%, P < .001). Logistic regression demonstrated that poor patients were approximately twice as likely to be not satisfied with the medical encounter and with various aspects of their communication with the physician. It is concluded that the parents of poor children are less satisfied with their care. Both policy and educational interventions may be needed to address this problem.

Key Words: poverty • patient satisfaction • quality of health care

Submitted on August 5, 1991
Accepted on February 5, 1992




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