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

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UNSPECIFIED. (2006) Patient characteristics and inequalities in doctors' diagnostic and management strategies relating to CHD: A video-simulation experiment. SOCIAL SCIENCE & MEDICINE, 62 (1). pp. 103-115. ISSN 0277-9536

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Official URL: http://dx.doi.org/10.1016/j.socscimed.2005.05.028

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. (c) 2005 Elsevier Ltd. All rights reserved.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
H Social Sciences
Journal or Publication Title: SOCIAL SCIENCE & MEDICINE
Publisher: PERGAMON-ELSEVIER SCIENCE LTD
ISSN: 0277-9536
Date: January 2006
Volume: 62
Number: 1
Number of Pages: 13
Page Range: pp. 103-115
Identification Number: 10.1016/j.socscimed.2005.05.028
Publication Status: Published
URI: http://wrap.warwick.ac.uk/id/eprint/34065

Data sourced from Thomson Reuters' Web of Knowledge

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