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Patient characteristics and inequalities in doctors’ diagnostic and management strategies in relation to CHD: A video-simulation experiment

Arber, S, McKinlay, J, Adams, A, Marceau, L, Link, C and O'Donnell, A (2007) Patient characteristics and inequalities in doctors’ diagnostic and management strategies in relation to CHD: A video-simulation experiment Social Science & Medicine, 62 (1). pp. 103-115.

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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.

Item Type: Article
Divisions : Faculty of Arts and Social Sciences > Department of Sociology
Authors :
AuthorsEmailORCID
Arber, SUNSPECIFIEDUNSPECIFIED
McKinlay, JUNSPECIFIEDUNSPECIFIED
Adams, AUNSPECIFIEDUNSPECIFIED
Marceau, LUNSPECIFIEDUNSPECIFIED
Link, CUNSPECIFIEDUNSPECIFIED
O'Donnell, AUNSPECIFIEDUNSPECIFIED
Date : 2007
Identification Number : 10.1016/j.socscimed.2005.05.028
Related URLs :
Additional Information : Notice: This is the author’s version of a work that was accepted for publication in <Social Science and Medicine> Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definite version was subsequently published in <Social Science and Medicine, 62 (1), 2007. DOI: 10.1016/j.socscimed.2005.05.028
Depositing User : Symplectic Elements
Date Deposited : 11 Jul 2013 14:38
Last Modified : 09 Jun 2014 13:36
URI: http://epubs.surrey.ac.uk/id/eprint/293564

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