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Published on: October 3, 2018
Ratings of Physician Communication by Caregivers of Hospitalized Children With and Without Autism
Kathleen Campbell1, Sean Cunningham2, Allison Neeley2,3
1Department of Pediatrics, University of Utah, Salt Lake City, Utah; and kathleen.campbell@hsc.utah.edu.
Insights
Caregivers of children with autism and without autism reported similar physician communication quality. Improving communication may enhance overall hospital ratings for all complex pediatric patients.
Area of Science:
- Pediatric Healthcare Quality
- Autism Spectrum Disorder Research
- Patient Communication Studies
Background:
- Investigating caregiver perceptions of physician communication and hospital ratings for hospitalized children.
- Comparing experiences of caregivers for children with and without autism.
Purpose of the Study:
- Assess associations between perceived physician communication quality and overall hospital ratings.
- Understand differences in hospital experiences for children with autism spectrum disorder.
Main Methods:
- Survey data from 543 caregivers of children with autism and 1086 controls.
- Analysis of Consumer Assessment of Healthcare Physicians and Systems Child Hospital Survey items.
- Multivariable regression models to examine communication-rating relationships.
Main Results:
- Similar proportions of caregivers reported high-quality physician communication (listening, respect) for children with and without autism.
- Caregivers of children with autism were less likely to recommend the hospital.
- Physician communication quality strongly correlated with hospital ratings and recommendations in both groups.
Conclusions:
- Matched caregiver groups reported comparable physician communication quality.
- Enhancing physician communication may improve hospital ratings for medically and socially complex children, including those with autism.
Background And Objectives:
To investigate caregivers' perceptions of physician communication and hospital ratings for hospitalized children with and without autism and assess associations between perceived quality of physician communication and overall ratings of the hospital.
Methods:
We studied survey data from caregivers of 543 patients with autism compared with a 2:1 matched control sample of 1086 patients with similar characteristics but without autism from a single children's hospital. We analyzed survey items related to physician communication and hospital ratings from the Consumer Assessment of Healthcare Physicians and Systems Child Hospital Survey. We constructed multivariable regression models to examine the relationship between caregiver-perceived physician communication and caregivers' overall ratings of the hospital.
Results:
A similar proportion of caregivers of children with and without autism reported that doctors "always" listened carefully to them (71.4% vs 74.3%; adjusted prevalence ratio 0.96; 95% confidence interval 0.90-1.03) and "always" treated them with respect (80.0% vs 84.1%; adjusted prevalence ratio 0.95; 95% confidence interval 0.90-1.00). Caregivers of children with autism were less likely to "definitely" recommend the hospital (87.0% vs 92.3%; adjusted prevalence ratio 0.94; 95% confidence interval 0.91-0.98). All items related to caregiver-perceived physician communication were associated with the highest hospital rating and the highest recommendation of the hospital in both groups.
Conclusions:
When matched on the basis of medical and social factors, caregivers of children with and without autism reported similar frequencies of highest-quality physician communication. Improvement of physician communication with caregivers of medically and socially complex children with and without autism may improve caregivers' overall ratings of the hospital.
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