Patient characteristics and inequalities in doctors’ diagnostic and management strategies relating to CHD: A video-simulation experiment
Numerous studies examine inequalities in health by gender, age, class and race, but few address the actions of primary care doctors. This factorial experiment examined how four patient characteristics impact on primary care doctors’ decisions regarding coronary heart disease (CHD). Primary care doct...
Gespeichert in:
| Veröffentlicht in: | Social science & medicine (1982) 2006, Vol.62 (1), p.103-115 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 115 |
|---|---|
| container_issue | 1 |
| container_start_page | 103 |
| container_title | Social science & medicine (1982) |
| container_volume | 62 |
| creator | Arber, Sara McKinlay, John Adams, Ann Marceau, Lisa Link, Carol O’Donnell, Amy |
| description | Numerous studies examine inequalities in health by gender, age, class and race, but few address the actions of primary care doctors. This factorial experiment examined how four patient characteristics impact on primary care doctors’ decisions regarding coronary heart disease (CHD).
Primary care doctors viewed a video-vignette of a scripted consultation where the patient presented with standardised symptoms of CHD. Videotapes were identical apart from varying patients’ gender, age (55 versus 75), class and race, thereby removing any confounding factors from the social context of the consultation or other aspects of patients’ symptomatology or behaviour. A probability sample of 256 primary care doctors in the UK and US viewed these video-vignettes in a randomised experimental design.
Gender of patient significantly influenced doctors’ diagnostic and management activities. However, there was no influence of social class or race, and no evidence of ageism in doctors’ behaviour. Women were asked fewer questions, received fewer examinations and had fewer diagnostic tests ordered for CHD. ‘Gendered ageism’ was suggested, since midlife women were asked fewest questions and prescribed least medication appropriate for CHD. Primary care doctors’ behaviour differed significantly by patients’ gender, suggesting doctors’ actions may contribute to gender inequalities in health. |
| doi_str_mv | 10.1016/j.socscimed.2005.05.028 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70189648</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0277953605002443</els_id><sourcerecordid>57202174</sourcerecordid><originalsourceid>FETCH-LOGICAL-c666t-9ef9793c2828052000aa11251158136a3d996e66e340026a05a748a386b7bba63</originalsourceid><addsrcrecordid>eNqFks2O0zAQxyMEYsvCK0CEtNxS7DjxB7eqfCxoJTjA2XKdaddVEndtp2JvnHkDXo8nYUyrInGp5Mkoyu8_mRn_i-IFJXNKKH-9nUdvo3UDdPOakHaeTy0fFDMqBata1oiHxYzUQlSqZfyieBLjlhBCiWSPiwvKCampErPi5xeTHIyptLcmGJsguJicjaUZu9KNcDeZ3iER8aXsvE0-xN8_fpWdM5vRZ_QvOZjRbGDIhWIKJsEmSwL0WH3clMmXy-u3b8pFuXcd-Cq6Ycqf_FjC9x3-MyufFo_Wpo_w7Jgvi2_v331dXlc3nz98XC5uKss5T5WCtRKK2VrWkrQ4PDGG0rqltJWUccM6pThwDqzBIbkhrRGNNEzylVitDGeXxatD3V3wdxPEpAcXLfS9GcFPUQtCpeKNPAtyyoSirTgPYpOsleos2Ioa70U0Z0EmEWs5QfDlf-DWT2HE_emakUZy2tQIiQNkg48xwFrvcOUm3GtKdPaT3uqTn3T2k86nziv4dFAG2IE9yQAA-QzvNTO8xsc9Bio5JodBMXY5E6bxZvRtGrDY82Ov0yprT00c3YjA1REw0Zp-HcxoXfzHCUaVkplbHDhAm-wdBI2tw2ihcwFs0p13Zyf7A2gXBsE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>230486142</pqid></control><display><type>article</type><title>Patient characteristics and inequalities in doctors’ diagnostic and management strategies relating to CHD: A video-simulation experiment</title><source>MEDLINE</source><source>RePEc</source><source>Sociological Abstracts</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Access via ScienceDirect (Elsevier)</source><creator>Arber, Sara ; McKinlay, John ; Adams, Ann ; Marceau, Lisa ; Link, Carol ; O’Donnell, Amy</creator><creatorcontrib>Arber, Sara ; McKinlay, John ; Adams, Ann ; Marceau, Lisa ; Link, Carol ; O’Donnell, Amy</creatorcontrib><description>Numerous studies examine inequalities in health by gender, age, class and race, but few address the actions of primary care doctors. This factorial experiment examined how four patient characteristics impact on primary care doctors’ decisions regarding coronary heart disease (CHD).
Primary care doctors viewed a video-vignette of a scripted consultation where the patient presented with standardised symptoms of CHD. Videotapes were identical apart from varying patients’ gender, age (55 versus 75), class and race, thereby removing any confounding factors from the social context of the consultation or other aspects of patients’ symptomatology or behaviour. A probability sample of 256 primary care doctors in the UK and US viewed these video-vignettes in a randomised experimental design.
Gender of patient significantly influenced doctors’ diagnostic and management activities. However, there was no influence of social class or race, and no evidence of ageism in doctors’ behaviour. Women were asked fewer questions, received fewer examinations and had fewer diagnostic tests ordered for CHD. ‘Gendered ageism’ was suggested, since midlife women were asked fewest questions and prescribed least medication appropriate for CHD. Primary care doctors’ behaviour differed significantly by patients’ gender, suggesting doctors’ actions may contribute to gender inequalities in health.</description><identifier>ISSN: 0277-9536</identifier><identifier>EISSN: 1873-5347</identifier><identifier>DOI: 10.1016/j.socscimed.2005.05.028</identifier><identifier>PMID: 16002197</identifier><identifier>CODEN: SSMDEP</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Age discrimination ; Age Factors ; Aged ; Ageism ; Biological and medical sciences ; Cardiovascular disease ; Class Differences ; Communication ; Coronary Disease - diagnosis ; Coronary Disease - therapy ; Coronary diseases ; Decision Making ; Diagnosis ; Doctor-Patient interactions ; Experiments ; Female ; Gender ; Gender Ageism Health inequalities Primary care Decision-making UK ; Gender equity ; Health inequalities ; Health inequality ; Heart Diseases ; Humans ; Male ; Medical Decision Making ; Medical sciences ; Middle Aged ; Miscellaneous ; Patient Education as Topic - methods ; Patients ; Physician-Patient Relations ; Physicians ; Practice Patterns, Physicians' - statistics & numerical data ; Practitioner Patient Relationship ; Prejudice ; Primary care ; Primary Health Care ; Primary Health Care - standards ; Primary health care professionals ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Racial discrimination ; Randomised experiment ; Sex Factors ; Sexism ; Sexual Inequality ; Social Class ; U.S.A ; UK/US ; United Kingdom ; United States ; United States of America ; US Randomised experiment</subject><ispartof>Social science & medicine (1982), 2006, Vol.62 (1), p.103-115</ispartof><rights>2005 Elsevier Ltd</rights><rights>2006 INIST-CNRS</rights><rights>Copyright Pergamon Press Inc. Jan 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c666t-9ef9793c2828052000aa11251158136a3d996e66e340026a05a748a386b7bba63</citedby><cites>FETCH-LOGICAL-c666t-9ef9793c2828052000aa11251158136a3d996e66e340026a05a748a386b7bba63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.socscimed.2005.05.028$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,4008,4024,27923,27924,27925,31000,33774,33775,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17319987$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16002197$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://econpapers.repec.org/article/eeesocmed/v_3a62_3ay_3a2006_3ai_3a1_3ap_3a103-115.htm$$DView record in RePEc$$Hfree_for_read</backlink></links><search><creatorcontrib>Arber, Sara</creatorcontrib><creatorcontrib>McKinlay, John</creatorcontrib><creatorcontrib>Adams, Ann</creatorcontrib><creatorcontrib>Marceau, Lisa</creatorcontrib><creatorcontrib>Link, Carol</creatorcontrib><creatorcontrib>O’Donnell, Amy</creatorcontrib><title>Patient characteristics and inequalities in doctors’ diagnostic and management strategies relating to CHD: A video-simulation experiment</title><title>Social science & medicine (1982)</title><addtitle>Soc Sci Med</addtitle><description>Numerous studies examine inequalities in health by gender, age, class and race, but few address the actions of primary care doctors. This factorial experiment examined how four patient characteristics impact on primary care doctors’ decisions regarding coronary heart disease (CHD).
Primary care doctors viewed a video-vignette of a scripted consultation where the patient presented with standardised symptoms of CHD. Videotapes were identical apart from varying patients’ gender, age (55 versus 75), class and race, thereby removing any confounding factors from the social context of the consultation or other aspects of patients’ symptomatology or behaviour. A probability sample of 256 primary care doctors in the UK and US viewed these video-vignettes in a randomised experimental design.
Gender of patient significantly influenced doctors’ diagnostic and management activities. However, there was no influence of social class or race, and no evidence of ageism in doctors’ behaviour. Women were asked fewer questions, received fewer examinations and had fewer diagnostic tests ordered for CHD. ‘Gendered ageism’ was suggested, since midlife women were asked fewest questions and prescribed least medication appropriate for CHD. Primary care doctors’ behaviour differed significantly by patients’ gender, suggesting doctors’ actions may contribute to gender inequalities in health.</description><subject>Age discrimination</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Ageism</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular disease</subject><subject>Class Differences</subject><subject>Communication</subject><subject>Coronary Disease - diagnosis</subject><subject>Coronary Disease - therapy</subject><subject>Coronary diseases</subject><subject>Decision Making</subject><subject>Diagnosis</subject><subject>Doctor-Patient interactions</subject><subject>Experiments</subject><subject>Female</subject><subject>Gender</subject><subject>Gender Ageism Health inequalities Primary care Decision-making UK</subject><subject>Gender equity</subject><subject>Health inequalities</subject><subject>Health inequality</subject><subject>Heart Diseases</subject><subject>Humans</subject><subject>Male</subject><subject>Medical Decision Making</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Patient Education as Topic - methods</subject><subject>Patients</subject><subject>Physician-Patient Relations</subject><subject>Physicians</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Practitioner Patient Relationship</subject><subject>Prejudice</subject><subject>Primary care</subject><subject>Primary Health Care</subject><subject>Primary Health Care - standards</subject><subject>Primary health care professionals</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Racial discrimination</subject><subject>Randomised experiment</subject><subject>Sex Factors</subject><subject>Sexism</subject><subject>Sexual Inequality</subject><subject>Social Class</subject><subject>U.S.A</subject><subject>UK/US</subject><subject>United Kingdom</subject><subject>United States</subject><subject>United States of America</subject><subject>US Randomised experiment</subject><issn>0277-9536</issn><issn>1873-5347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>X2L</sourceid><sourceid>BHHNA</sourceid><sourceid>7QJ</sourceid><recordid>eNqFks2O0zAQxyMEYsvCK0CEtNxS7DjxB7eqfCxoJTjA2XKdaddVEndtp2JvnHkDXo8nYUyrInGp5Mkoyu8_mRn_i-IFJXNKKH-9nUdvo3UDdPOakHaeTy0fFDMqBata1oiHxYzUQlSqZfyieBLjlhBCiWSPiwvKCampErPi5xeTHIyptLcmGJsguJicjaUZu9KNcDeZ3iER8aXsvE0-xN8_fpWdM5vRZ_QvOZjRbGDIhWIKJsEmSwL0WH3clMmXy-u3b8pFuXcd-Cq6Ycqf_FjC9x3-MyufFo_Wpo_w7Jgvi2_v331dXlc3nz98XC5uKss5T5WCtRKK2VrWkrQ4PDGG0rqltJWUccM6pThwDqzBIbkhrRGNNEzylVitDGeXxatD3V3wdxPEpAcXLfS9GcFPUQtCpeKNPAtyyoSirTgPYpOsleos2Ioa70U0Z0EmEWs5QfDlf-DWT2HE_emakUZy2tQIiQNkg48xwFrvcOUm3GtKdPaT3uqTn3T2k86nziv4dFAG2IE9yQAA-QzvNTO8xsc9Bio5JodBMXY5E6bxZvRtGrDY82Ov0yprT00c3YjA1REw0Zp-HcxoXfzHCUaVkplbHDhAm-wdBI2tw2ihcwFs0p13Zyf7A2gXBsE</recordid><startdate>2006</startdate><enddate>2006</enddate><creator>Arber, Sara</creator><creator>McKinlay, John</creator><creator>Adams, Ann</creator><creator>Marceau, Lisa</creator><creator>Link, Carol</creator><creator>O’Donnell, Amy</creator><general>Elsevier Ltd</general><general>Elsevier</general><general>Pergamon Press Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>DKI</scope><scope>X2L</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U3</scope><scope>7U4</scope><scope>8BJ</scope><scope>BHHNA</scope><scope>DWI</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>WZK</scope><scope>7QJ</scope><scope>7X8</scope></search><sort><creationdate>2006</creationdate><title>Patient characteristics and inequalities in doctors’ diagnostic and management strategies relating to CHD: A video-simulation experiment</title><author>Arber, Sara ; McKinlay, John ; Adams, Ann ; Marceau, Lisa ; Link, Carol ; O’Donnell, Amy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c666t-9ef9793c2828052000aa11251158136a3d996e66e340026a05a748a386b7bba63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Age discrimination</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Ageism</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular disease</topic><topic>Class Differences</topic><topic>Communication</topic><topic>Coronary Disease - diagnosis</topic><topic>Coronary Disease - therapy</topic><topic>Coronary diseases</topic><topic>Decision Making</topic><topic>Diagnosis</topic><topic>Doctor-Patient interactions</topic><topic>Experiments</topic><topic>Female</topic><topic>Gender</topic><topic>Gender Ageism Health inequalities Primary care Decision-making UK</topic><topic>Gender equity</topic><topic>Health inequalities</topic><topic>Health inequality</topic><topic>Heart Diseases</topic><topic>Humans</topic><topic>Male</topic><topic>Medical Decision Making</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Patient Education as Topic - methods</topic><topic>Patients</topic><topic>Physician-Patient Relations</topic><topic>Physicians</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Practitioner Patient Relationship</topic><topic>Prejudice</topic><topic>Primary care</topic><topic>Primary Health Care</topic><topic>Primary Health Care - standards</topic><topic>Primary health care professionals</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Racial discrimination</topic><topic>Randomised experiment</topic><topic>Sex Factors</topic><topic>Sexism</topic><topic>Sexual Inequality</topic><topic>Social Class</topic><topic>U.S.A</topic><topic>UK/US</topic><topic>United Kingdom</topic><topic>United States</topic><topic>United States of America</topic><topic>US Randomised experiment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arber, Sara</creatorcontrib><creatorcontrib>McKinlay, John</creatorcontrib><creatorcontrib>Adams, Ann</creatorcontrib><creatorcontrib>Marceau, Lisa</creatorcontrib><creatorcontrib>Link, Carol</creatorcontrib><creatorcontrib>O’Donnell, Amy</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>RePEc IDEAS</collection><collection>RePEc</collection><collection>CrossRef</collection><collection>Social Services Abstracts</collection><collection>Sociological Abstracts (pre-2017)</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>Sociological Abstracts</collection><collection>Sociological Abstracts</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Sociological Abstracts (Ovid)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>Social science & medicine (1982)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arber, Sara</au><au>McKinlay, John</au><au>Adams, Ann</au><au>Marceau, Lisa</au><au>Link, Carol</au><au>O’Donnell, Amy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient characteristics and inequalities in doctors’ diagnostic and management strategies relating to CHD: A video-simulation experiment</atitle><jtitle>Social science & medicine (1982)</jtitle><addtitle>Soc Sci Med</addtitle><date>2006</date><risdate>2006</risdate><volume>62</volume><issue>1</issue><spage>103</spage><epage>115</epage><pages>103-115</pages><issn>0277-9536</issn><eissn>1873-5347</eissn><coden>SSMDEP</coden><abstract>Numerous studies examine inequalities in health by gender, age, class and race, but few address the actions of primary care doctors. This factorial experiment examined how four patient characteristics impact on primary care doctors’ decisions regarding coronary heart disease (CHD).
Primary care doctors viewed a video-vignette of a scripted consultation where the patient presented with standardised symptoms of CHD. Videotapes were identical apart from varying patients’ gender, age (55 versus 75), class and race, thereby removing any confounding factors from the social context of the consultation or other aspects of patients’ symptomatology or behaviour. A probability sample of 256 primary care doctors in the UK and US viewed these video-vignettes in a randomised experimental design.
Gender of patient significantly influenced doctors’ diagnostic and management activities. However, there was no influence of social class or race, and no evidence of ageism in doctors’ behaviour. Women were asked fewer questions, received fewer examinations and had fewer diagnostic tests ordered for CHD. ‘Gendered ageism’ was suggested, since midlife women were asked fewest questions and prescribed least medication appropriate for CHD. Primary care doctors’ behaviour differed significantly by patients’ gender, suggesting doctors’ actions may contribute to gender inequalities in health.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>16002197</pmid><doi>10.1016/j.socscimed.2005.05.028</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0277-9536 |
| ispartof | Social science & medicine (1982), 2006, Vol.62 (1), p.103-115 |
| issn | 0277-9536 1873-5347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_70189648 |
| source | MEDLINE; RePEc; Sociological Abstracts; Applied Social Sciences Index & Abstracts (ASSIA); Access via ScienceDirect (Elsevier) |
| subjects | Age discrimination Age Factors Aged Ageism Biological and medical sciences Cardiovascular disease Class Differences Communication Coronary Disease - diagnosis Coronary Disease - therapy Coronary diseases Decision Making Diagnosis Doctor-Patient interactions Experiments Female Gender Gender Ageism Health inequalities Primary care Decision-making UK Gender equity Health inequalities Health inequality Heart Diseases Humans Male Medical Decision Making Medical sciences Middle Aged Miscellaneous Patient Education as Topic - methods Patients Physician-Patient Relations Physicians Practice Patterns, Physicians' - statistics & numerical data Practitioner Patient Relationship Prejudice Primary care Primary Health Care Primary Health Care - standards Primary health care professionals Public health. Hygiene Public health. Hygiene-occupational medicine Racial discrimination Randomised experiment Sex Factors Sexism Sexual Inequality Social Class U.S.A UK/US United Kingdom United States United States of America US Randomised experiment |
| title | Patient characteristics and inequalities in doctors’ diagnostic and management strategies relating to CHD: A video-simulation experiment |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T22%3A40%3A12IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Patient%20characteristics%20and%20inequalities%20in%20doctors%E2%80%99%20diagnostic%20and%20management%20strategies%20relating%20to%20CHD:%20A%20video-simulation%20experiment&rft.jtitle=Social%20science%20&%20medicine%20(1982)&rft.au=Arber,%20Sara&rft.date=2006&rft.volume=62&rft.issue=1&rft.spage=103&rft.epage=115&rft.pages=103-115&rft.issn=0277-9536&rft.eissn=1873-5347&rft.coden=SSMDEP&rft_id=info:doi/10.1016/j.socscimed.2005.05.028&rft_dat=%3Cproquest_cross%3E57202174%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=230486142&rft_id=info:pmid/16002197&rft_els_id=S0277953605002443&rfr_iscdi=true |