664 - The association between patient-provider racial congruence on pediatric patient and family experience

We conducted a retrospective analysis of routine ambulatory PFE survey data collected between June 2020 and May 2022 at a single large, pediatric medical center. Surveys were administered by NRC Health. PFE survey data were linked to patient demographic characteristics (race, ethnicity, and markers of neighborhood deprivation attached to geocoded home addresses). Provider demographic characteristics were obtained from a human resource database that includes self-reported gender, age, race, and ethnicity. Outcomes were: 1. overall PFE rating of provider as measured on an 11-point Likert scale, with higher being better (% of 9s or 10s); and 2. questions measuring respect, communication (listening and explaining), and feelings of safety (% “yes, definitely”). We examined associations between provider demographics (gender, generation, race, ethnicity) and PFE, controlling for patient demographics (race, ethnicity, neighborhood social deprivation) and site of care (primary vs. subspecialty) using chi-square tests. We examined the association between racial congruence and PFE ratings using multivariable logistic regression.

Results:

We analyzed 89,175 surveys with a response rate of 15.6% (Table 1). There were no significant differences in PFE scores by provider race/ethnicity (Table 2). In bivariate analyses, patients from each racial group did not score providers differently based on the provider’s race. Multivariable logistic regression models demonstrated that racial discordance between patients and providers was associated with significantly lower experience ratings for four of the PFE questions (Table 3). Racial discordance was significantly associated with measures of communication and respect but not with the overall rating of the provider.

Conclusion(s):

Pediatric patient and family experiences were lower when patients and providers had discordant racial identities. Our findings highlight the potential impact of racism and social deprivation on PFE and further supports the need for increased provider racial diversity and investments to address social determinants of health.