Patient-provider racial and ethnic concordance and parent reports of the primary care experiences of children.

Abstract

PURPOSE: Studies among adults suggest that patient-provider racial concordance is associated with higher satisfaction and partnership with physicians. It remains unknown whether similar findings are true for children. This study examines the association of race/ethnicity concordance with parent reports of children's primary care experiences. METHODS: We completed telephone interviews with a random, cross-sectional sample of 413 parents of elementary school children, aged 5 to 12 years, enrolled in a single large school district serving 3 cities in San Bernardino, Calif. Parents reported on their children's primary care experiences, and the responses were compared between children in race concordant and discordant patient-provider relationships. RESULTS: We assessed parent reports of 6 structure and process features of primary care: first-contact care (accessibility, utilization), longitudinality (strength of affiliation, interpersonal relationship), and comprehensiveness (services offered, received). Before and after controlling for demographics, socioeconomic status, and health system factors, race/ethnicity concordance was not associated with children's primary care experiences. Minority parents generally reported poorer experiences than whites in several domains of primary care, but the only significant effect of race/ethnicity concordance was slightly better primary care utilization for whites in concordant relationships, which did not hold after adjustment. CONCLUSION: In contrast with studies among adults, patient-provider race/ethnicity concordance was not associated with parent reports of primary care experiences in our sample of children. It is possible that provider biases or patient expectations that contribute to disparities in care for adults are attenuated in relationships involving children.