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Keys to Improving Parent Satisfaction in the Pediatric Urology Clinic: A Starting Point
Carol A. Davis-Dao, PhD1, Louis Ehwerhemuepha, PhD1, Joshua D. Chamberlin, MD2, William Feaster, MD1, Antoine E. Khoury, MD2, Zeev N. Kain, MD2.
1Children's Hospital of Orange County, Orange, CA, USA, 2University of California Irvine, Children's Hospital of Orange County, Orange, CA, USA.

BACKGROUND: The future of health care payments and reimbursements are directed towards value-based care, patient reported outcomes and patient satisfaction and away from the traditional fee for service model. Our objective is to evaluate contextual factors that predict parent satisfaction in the pediatric urology clinic.
METHODS: Data from the National Research Corporation (NCR) Health Patient Survey and demographic and visit-related information from electronic health records (EHR) were collected from a pediatric urology clinic at a children's hospital between January 2017 and January 2019. Rating of provider on the NCR survey was chosen as the primary outcome for analysis and treated as per the standard in this field, binary with values 9-10 indicating satisfaction with the provider and 0-8 indicating lack of satisfaction. Univariate and multivariate analyses were conducted using logistic regression and estimating odds ratios and corresponding 95% confidence intervals and p values. Two multivariate models were conducted: (1) a model containing the demographic and visit-related data and (2) a model containing the survey data.
RESULTS: A total of 3232 surveys were included in this analysis. NCR survey data were merged with EHR demographic and visit-related data. Multivariate analysis of the demographic and visit data found that the significant predictors of parent satisfaction were: low income insurance (Medicaid) (OR = 1.3 (95% CI: 1.1, 1.6) (p = 0.035), primary language Spanish (OR = 1.5 (95% CI: 1.1, 2.0) (p = 0.012), and shorter waiting time during the visit (OR = 0.94 (95% CI: 0.91, 0.97) (p < 0.001). Multivariate analysis of NCR survey data identified physician explanation, listening, respect for patient, time spent with patient and communication between physicians and nurses as highly significant predictors of satisfaction (p < 0.001).
CONCLUSIONS: Certain patient populations may inherently be more satisfied with the outpatient clinic experience. Several factors related to physician-patient communication are modifiable areas to improve parent satisfaction.


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