1 Evaluating Pediatric Residents’ Knowledge of Patient Advocacy Resources

Pediatricians often manage complex health care needs. Many of these families experience financial burden due to their child’s condition. There are a multitude of organizations offering financial assistance. To obtain this funding, families need knowledge of the programs and application forms to be properly completed. It is a physician’s responsibility to work with patients to address determinants of health and access to required health services, including financial and social supports. Currently there is no formal training in our pediatric residency program regarding financial support for families. The objectives of this study were to assess pediatric residents’ knowledge of financial supports and social services available to their patients, and determine curriculum development needs in this area. An 18-question survey was distributed to pediatric residents in one Canadian program, assessing experience and knowledge, as well as demographics. The survey was administered through REDCap© software and distributed electronically in June 2018. Ethics approval was obtained from the regional Research Ethics Board. One-way ANOVA was used to compare responses by postgraduate year (PGY). There were 23 respondents (response rate 42%). All identified that they did not feel they had adequate knowledge to identify nor complete financial assistance forms. Of the 17 financial assistance services listed, residents were aware of a mean of six, with no variation between PGYs (p=0.17). Sixty-one percent had never completed a financial assistance form. More senior residents were more likely to have completed at least one form (p<0.05). Settings where forms were completed were variable. Five questions assessing residents’ knowledge of specific aspects of financial assistance were included in the survey. The overall percentage correct was 16.5%. There was no significant variation between correct responses and PGY (p=0.94). Five of the 23 residents (22%) had received formal or informal teaching on financial assistance. All respondents felt that there is a need for more exposure to financial assistance in residency. Knowledge of financial supports is integral for patient advocacy. Residents in our pediatric program have inadequate knowledge of financial supports and social services available to patients. Respondents lacked both knowledge of and exposure to services. They had minimal experience completing financial assistance forms. Residents across all PGYs identified a need for additional resources on financial support. In the future, this study could be extended to pediatricians to determine if knowledge improves once in practice.