Do poor patients suffer from inaccurate diagnoses more than well-to-do patients? A randomized control trial

Poor patients have greater morbidity and die up to 10 years earlier than patients who have higher socio-economic status. These findings are often attributed to differences in life-style between groups. The present study aimed at investigating the extent to which physicians contribute to the effect b...

Full description

Saved in:
Bibliographic Details
Published in:BMC medical education 2019-10, Vol.19 (1), p.386-386, Article 386
Main Authors: Al Alwan, Ibrahim, Magzoub, Mohi Eldin, Al Haqwi, Ali, Badri, Motasin, Al Yousif, Sarah M, Babiker, Amir, Mamede, Sílvia, Schmidt, Henk G
Format: Article
Language:English
Subjects:
Adult
Clinical reasoning
Delivery of Health Care - ethics
Delivery of Health Care - statistics & numerical data
Demographic aspects
Diagnostic Errors - statistics & numerical data
Female
Health aspects
Health Services Research
Healthcare Disparities - statistics & numerical data
Humans
Internal Medicine - ethics
Male
Medical errors
Poor
Prejudice
Rich
Saudi Arabia
Social Class
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Poor patients have greater morbidity and die up to 10 years earlier than patients who have higher socio-economic status. These findings are often attributed to differences in life-style between groups. The present study aimed at investigating the extent to which physicians contribute to the effect by providing relative poorer care, resulting in relative neglect in terms of time spent with a poor patient and more inaccurate diagnoses. A randomised experiment with 45 internal medicine residents. Doctors diagnosed 12 written clinical vignettes that were exactly the same except for the description of the patients' socio-economic status. Each participant diagnosed four of the vignettes in a poor-patient version, four in a rich-patient version, and four in a version that did not contain socio-economic markers, in a balanced within-subjects incomplete block design. Main measurements were: diagnostic accuracy scores and time spent on diagnosis. Mean diagnostic accuracy scores (range 0-1) did not significantly differ among the conditions of the experiment (for poor patients: 0.48; for rich patients: 0.52; for patients without socio-economic markers: 0.54; p > 0.05). While confronted with patients not presenting with socio-economic background information, the participants spent significantly less time-to-diagnosis ((for poor patients: 168 s; for rich patients: 176 s; for patients without socio-economic markers: 151 s; p 
ISSN:1472-6920
1472-6920
DOI:10.1186/s12909-019-1805-6