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J Racial Ethn Health Disparities. 2017 Dec;4(6):1051-1060. doi: 10.1007/s40615-016-0309-x. Epub 2017 Mar 8.

Factors That Matter to Low-Income and Racial/Ethnic Minority Mothers When Choosing a Pediatric Practice: a Mixed Methods Analysis.

Author information

1
Center for Quality of Care Research, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA. sarah.goffmd@baystatehealth.org.
2
Department of Medicine, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA. sarah.goffmd@baystatehealth.org.
3
Department of Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111,, USA. sarah.goffmd@baystatehealth.org.
4
, 280 Chestnut St., Room 305, Springfield, MA, 01104,, USA. sarah.goffmd@baystatehealth.org.
5
University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA, 01655,, USA.
6
Meyers Primary Care Institute, University of Massachusetts Medical School, 425 North Lake Avenue, Worcester, MA, 01605,, USA.
7
Center for Quality of Care Research, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA.
8
Department of Medicine, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA.
9
Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114,, USA.
10
Renal and Transplant Associates of New England, 100 Wason Ave # 200, Springfield, MA, 01107,, USA.
11
Department of Obstetrics and Gynecology, Boston Medical Center, 720 Harrison Ave, Boston, MA, 02118,, USA.
12
University of Massachusetts School of Public Health and Health Sciences, Amherst, MA, 01003,, USA.
13
Department of Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111,, USA.

Abstract

BACKGROUND:

Pediatric practices' scores on healthcare quality measures are increasingly available to the public. However, patients from low-income and racial/ethnic minority populations rarely use these data. We sought to understand potential barriers to using quality data by assessing what factors mattered to women when choosing a pediatric practice.

METHODS:

As part of a randomized trial to overcome barriers to using quality data, we recruited women from a prenatal clinic serving an underserved population. Women reported how much 12 factors mattered when they chose a pediatric practice (5-point Likert scale), what other factors mattered to them, and which factors mattered the most. We assessed whether factor importance varied with selected participant characteristics and qualitatively analyzed the "other" factors named.

RESULTS:

Participants' (n = 367) median age was 23 years, and they were largely Hispanic (60.4%), white (21.2%), or black (16.9%). Insurance acceptance "mattered a lot" to the highest percentage of women (93.2%), while online information about what other parents think of a practice "mattered a lot" to the fewest (7.4%). Major themes from our qualitative analysis of "other" factors that mattered included physicians' interpersonal skills and pediatrician-specific traits. Factors related to access "mattered the most" to the majority of women.

CONCLUSIONS:

Pediatrician characteristics and factors related to access to care may be more important to low-income and racial/ethnic minority women than more commonly reported quality metrics. Aligning both the content and delivery of publicly reported quality data with women's interests may increase use of pediatric quality data.

CLINICAL TRIAL REGISTRATION:

Clinicaltrials.gov NCT01784575.

KEYWORDS:

Choosing a pediatric practice; Low income; Minority; Pediatric healthcare quality; Pregnant women

PMID:
28275998
PMCID:
PMC5875937
DOI:
10.1007/s40615-016-0309-x
[Indexed for MEDLINE]
Free PMC Article

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