MEASURING SATISFACTION WITH WELL CHILD CARE: TECHNICAL AND INTERPERSONAL QUALITY Neal Halfon, Moira Inkelas, Mark A. Schuster, Lynn M. Olson, Ritesh Mistry, Christina D. Bethell Pediatrics, UCLA, Los Angeles, CA; Public Health, UCLA, Los Angeles, CA; Rand, Santa Monica, CA; American Academy of Pediatrics, Elk Grove Village, IL; FACCT - The Foundation for Accountability, Portland, OR

BACKGROUND: Patient satisfaction, used to rate and market health care, includes both technical and interpersonal quality. Studies show parents of young children want more guidance about development, but their expectations may not encompass the full content of recommended health supervision. Thus topics discussed may not influence satisfaction ratings. Few studies examine how parent ratings of well child care relate to health supervision received, and to measures of interpersonal quality.

OBJECTIVE: To examine the relationship between satisfaction with check-ups for young children, and content and process of well child care.

DESIGN/METHODS: The National Survey of Early Childhood Health (NSECH) is a telephone survey of 2,068 parents of children age 4 to 35 months that profiles content and quality of health care for children. Measures include 21 age-appropriate health supervision content items (discussed or not; if not discussed, would it be helpful), a summary (process) rating of family-centered care (range 0 to 10), and a satisfaction rating with check-ups over the past 12 months (range 0 to 10).

RESULTS: Satisfaction with check-ups is high (mean 8.7, s.e. 0.04). As expected, for most topics (18 of 21), satisfaction ratings are lowest for parents who did not discuss a topic but felt it would be helpful. In multivariate OLS, controlling for other factors likely to affect ratings independent of health care content (child age, race/ethnicity, health status, other children in household, maternal education), satisfaction remains lower when the topic was not discussed but thought helpful. Multivariate models predicting family centered care reports show lower scores when a topic was not discussed but thought helpful, for all topics. In multivariate OLS controlling for other factors, satisfaction ratings and family centered care reports increase with the total number of topics discussed. Satisfaction ratings and family centered care reports are also positively correlated with summary measures of topics discussed.

CONCLUSIONS: Global satisfaction with well child care is high, but sensitive to content. Although parents may not be aware of the full potential of preventive care, satisfaction measures parallel the reports of health supervision received.