Factors Associated With Patient- and Family-Centered Care in the Hispanic Pediatric Population: A Secondary Analysis

Despite the documented benefits of patient- and family-centered care (PFCC), Hispanic children experience significantly lower rates of PFCC compared to non-Hispanic children. This study aimed to identify specific factors associated with the receipt of PFCC among Hispanic children.

Using data from the 2020-21 National Survey of Children's Health, cross-sectional secondary analyses were conducted to examine caregiver-reported clinician- and practice-level contributors to disparities in PFCC, specifically focusing on family-centered care (FCC) and shared decision-making (SDM) among US Hispanic versus non-Hispanic children and youth. Descriptive statistics were used to characterize social, demographic, and health care experiences. Stratified multivariable logistic regression analyses evaluated, among Hispanic children, associations of FCC/SDM with key covariates. All analyses were weighted to account for the complex survey design.

Among 93,669 respondents (representing approximately 72.7 million noninstitutionalized US children and youth, 25.7% identifying as Hispanic or Latino), caregivers of Hispanic children were significantly less likely to report experiencing FCC and SDM if they had gaps in insurance coverage (FCC adjusted odds ratio [aOR] = 0.53, 95% Confidence Interval (CI): 0.37, 0.76; SDM aOR = 0.38, 95% CI: 0.18, 0.80) or lived in households where English was not the primary language (FCC aOR = 0.68, 95% CI: 0.52, 0.89; SDM aOR = 0.53, 95% CI: 0.33, 0.87). Additionally, not having a personal doctor was associated with lower odds of reporting FCC (aOR = 0.44, 95% CI: 0.34, 0.57).

A lack of stable relationships with personal doctors and limited availability of language-appropriate services were significantly associated with lower reports of PFCC and SDM among Hispanic children. These associations highlight potential targets for further research and quality improvement.