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Women and men with coronary heart disease in three countries; Are they treated differently?

Bonte, M, von dem Knesebeck, O, Siegerist, J, Marceau, L, Link, C, Arber, S, Adams, A and McKinlay, JB (2008) Women and men with coronary heart disease in three countries; Are they treated differently? Women’s Health Issues, 18 (3). pp. 191-198.

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Abstract

Background Nonmedical determinants of medical decision making were investigated in an international research project in the United States, the United Kingdom, and Germany. The key question in this paper is whether and to what extent doctors' diagnostic and therapeutic decisions in coronary heart disease (CHD) are influenced by patient gender. Methods A factorial experiment with a videotaped patient consultation was conducted. Professional actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patient-actors of different gender, age, race, and socioeconomic status. The videotapes were presented to a randomly selected sample of 128 primary care physicians in each country. Using an interview with standardized and open-ended questions, physicians were asked how they would diagnose and treat such a patient after they had seen the video. Results Results show gender differences in the diagnostic strategies of the doctors. Women were asked different questions, CHD was mentioned more often as a possible diagnosis for men than for women, and physicians were less certain about their diagnosis with female patients. Gender differences in management decisions (therapy and lifestyle advice) are less pronounced and less consistent than in diagnostic decisions. Magnitude of gender effect on doctors' decisions varies between countries with smaller influences in the United States. Conclusion Although patients with identical symptoms were presented, primary care doctors' behavior differed by patients' gender in all 3 countries under study. These gender differences suggest that women may be less likely to receive an accurate diagnosis and appropriate treatment than men.

Item Type: Article
Divisions : Faculty of Arts and Social Sciences > Department of Sociology
Authors :
AuthorsEmailORCID
Bonte, MUNSPECIFIEDUNSPECIFIED
von dem Knesebeck, OUNSPECIFIEDUNSPECIFIED
Siegerist, JUNSPECIFIEDUNSPECIFIED
Marceau, LUNSPECIFIEDUNSPECIFIED
Link, CUNSPECIFIEDUNSPECIFIED
Arber, SUNSPECIFIEDUNSPECIFIED
Adams, AUNSPECIFIEDUNSPECIFIED
McKinlay, JBUNSPECIFIEDUNSPECIFIED
Date : 2008
Identification Number : 10.1016/j.whi.2008.01.003
Related URLs :
Additional Information : NOTICE: this is the author’s version of a work that was accepted for publication in <Women’s Health Issues>. 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 definitive version was subsequently published in Women’s Health Issues, 18(3), 2008. DOI: 10.1016/j.whi.2008.01.003”
Depositing User : Symplectic Elements
Date Deposited : 31 Jan 2013 11:25
Last Modified : 23 Sep 2013 19:44
URI: http://epubs.surrey.ac.uk/id/eprint/729418

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