Assessing the relationship between the quality of patient-provider communication and healthcare use by pediatric populations

Background
Effective communication is vital in healthcare. It improves the quality of care, treatment adherence, and follow-up. However, the extent to which communication gaps impact healthcare utilization, such as hospital inpatient and ED use within the pediatric population, is less understood. This study aims to bridge the gap in the literature.

Methods
The study used the 2019–2023 National Survey of Children’s Health (NSCH) data to examine the relationship between perceived communication quality and healthcare utilization within the pediatric population. The primary independent variable, perceived patient-provider communication quality, was a composite score derived from five items evaluating the quality of provider-patient communication. We conducted two survey-weighted multivariable logistic regressions to evaluate the relationship between perceived patient-provider communication quality and two outcome variables of interest – emergency department utilization and hospital stay – while controlling for potential confounding variables.

Results
From 2019 to 2023, over 26 million parents of children reported inadequacies in the quality of communication with their children’s providers. Approximately 35% of them belonged to minority racial groupings. In adjusted models, children whose parents reported lower quality of communication with the child's providers were more likely to visit the emergency room (OR = 1.30, 95% CI = 1.23–1.37) and require hospitalization (OR =  1.27, 95% CI = 1.14–1.42). Being a Black /African American child, compared to Non-Hispanic White (OR =  1.27, 95% CI = 1.16–1.38), was significantly and positively associated with ER visits but not hospital stays.

Conclusions
Inadequate provider-patient communication may increase the likelihood of children using emergency department and inpatient services.