Parent antibiotics knowledge, expectations, physician perceptions, and antibiotic prescribing behavior: How do Latino immigrants fare

An increasing number of studies have demonstrated that health status and quality of care vary by ethnicity. Little attention has been given to examining the quality of the medical treatment that Latino immigrants obtain and even less is known about the quality of care that the children of these individuals receive. This dissertation stresses the importance of examining factors that affect the quality of care and medical treatment that the children of primarily Spanish-speaking Latino immigrants receive for the treatment of upper respiratory infections. Specifically, I examine whether these children are at increased risk for inappropriate antibiotic prescriptions.;Using previously gathered survey data from Mangione-Smith's 2004 study and my own original data from Spanish-speaking medical visits, I use survey data analysis to examine the role that previously neglected factors as well as parent, child, and physician sociodemographic characteristics and clinical observations have on parent antibiotics knowledge, expectations, physician perception and antibiotic prescribing behavior. I show that structural factors explain variances that otherwise would be perceived to be an artifacts of culture. I draw comparisons between and among Spanish-responding and English-responding Latino parents, Asian, Black, and white parents who reside in the general Los Angeles area.;Unlike previous studies, I found that variance in prescribing behavior by parent ethnicity is mostly explained by physician characteristics such as ethnicity and clinical observations and that parent and patient demographics have little impact on physician prescribing behavior. I confirm previously published findings and provide yet another alarming observation: The children of Latino Spanish-responding parents are at greater risk of receiving inappropriate antibiotic prescriptions than other children. These parents know the least about the appropriate use of antibiotics; have the highest expectations for a prescription; have the least amount of physician interaction time; are highly perceived as expecting an antibiotic; have the highest number of bacterial diagnoses; and are prescribed antibiotics at higher rates than any other ethnic group. This bleak outlook in the fight against antibiotic resistance is amplified with my finding that the children of Latino Spanish-responding parents also have the highest number of inappropriate antibiotic prescriptions compared to all other ethnic groups.