IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v62y2006i1p103-115.html
   My bibliography  Save this article

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

Author

Listed:
  • Arber, Sara
  • McKinlay, John
  • Adams, Ann
  • Marceau, Lisa
  • Link, Carol
  • O'Donnell, Amy

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.

Suggested Citation

  • Arber, Sara & McKinlay, John & Adams, Ann & Marceau, Lisa & Link, Carol & O'Donnell, Amy, 2006. "Patient characteristics and inequalities in doctors' diagnostic and management strategies relating to CHD: A video-simulation experiment," Social Science & Medicine, Elsevier, vol. 62(1), pages 103-115, January.
    • Handle: RePEc:eee:socmed:v:62:y:2006:i:1:p:103-115
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00244-3
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Bartley, M. & Sacker, A. & Firth, D. & Fitzpatrick, R., 1999. "Understanding social variation in cardiovascular risk factors in women and men: the advantage of theoretically based measures," Social Science & Medicine, Elsevier, vol. 49(6), pages 831-845, September.
    2. Shaw, Mary & Maxwell, Roy & Rees, Karen & Ho, Davidson & Oliver, Steven & Ben-Shlomo, Yoav & Ebrahim, Shah, 2004. "Gender and age inequity in the provision of coronary revascularisation in England in the 1990s: is it getting better?," Social Science & Medicine, Elsevier, vol. 59(12), pages 2499-2507, December.
    3. Ronica N. Rooks & Eleanor M. Simonsick & Toni Miles & Anne Newman & Stephen B. Kritchevsky & Richard Schulz & Tamara Harris, 2002. "The Association of Race and Socioeconomic Status With Cardiovascular Disease Indicators Among Older Adults in the Health, Aging, and Body Composition Study," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 57(4), pages 247-256.
    4. Macintyre, Sally, 1997. "The black report and beyond what are the issues?," Social Science & Medicine, Elsevier, vol. 44(6), pages 723-745, March.
    5. Crawford, S.L. & McGraw, S.A. & Smith, K.W. & McKinlay, J.B. & Pierson, J.E., 1994. "Do blacks and whites differ in their use of health care for symptoms of coronary heart disease?," American Journal of Public Health, American Public Health Association, vol. 84(6), pages 957-964.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. MacLean, Alice & Hunt, Kate & Smith, Sarah & Wyke, Sally, 2017. "Does gender matter? An analysis of men's and women's accounts of responding to symptoms of lung cancer," Social Science & Medicine, Elsevier, vol. 191(C), pages 134-142.
    2. Luca Fumarco & Benjamin Harrell & Patrick Button & David Schwegman & E Dils, 2020. "Gender Identity, Race, and Ethnicity-based Discrimination in Access to Mental Health Care: Evidence from an Audit Correspondence Field Experiment," NBER Working Papers 28164, National Bureau of Economic Research, Inc.
    3. Ballering, Aranka V. & Bonvanie, Irma J. & Olde Hartman, Tim C. & Monden, Rei & Rosmalen, Judith G.M., 2020. "Gender and sex independently associate with common somatic symptoms and lifetime prevalence of chronic disease," Social Science & Medicine, Elsevier, vol. 253(C).
    4. Caro, Francis G. & Yee, Christine & Levien, Samantha & Gottlieb, Alison S. & Winter, Joachim & McFadden, Daniel L. & Ho, Teck H., 2012. "Choosing among residential options: Results of a vignette experiment," Munich Reprints in Economics 19970, University of Munich, Department of Economics.
    5. Andrea Cabezas-Rodríguez & Amaia Bacigalupe & Unai Martín, 2020. "Diagnosis and Treatment of Depression in Spain: Are There Gender Inequalities?," IJERPH, MDPI, vol. 17(24), pages 1-10, December.
    6. François Birault & Lakshmipriva Le Bonheur & Nicolas Langbour & Sandivanie Clodion & Nematollah Jaafari & Marie-Christine Perault-Pochat & Bérangère Thirioux, 2022. "Exposure to High Precariousness Prevalence Negatively Impacts Drug Prescriptions of General Practitioners to Precarious and Non-Precarious Populations: A Retrospective Pharmaco-Epidemiological Study," IJERPH, MDPI, vol. 19(5), pages 1-23, March.
    7. Huang, Nicole & Chou, Yiing-Jenq & Hu, Hsiao-Yun & Lee, Cheng-Hua, 2013. "Gender disparities in AMI management and outcomes among health professionals, their relatives, and non-health professionals in Taiwan from 1997 to 2007," Social Science & Medicine, Elsevier, vol. 77(C), pages 70-74.
    8. Caro, Francis G. & Ho, Teck H. & McFadden, Daniel L. & Gottlieb, Alison S. & Yee, Christine & Chan, Taizan & Winter, Joachim, 2012. "Using the internet to administer more realistic vignette experiments," Munich Reprints in Economics 19971, University of Munich, Department of Economics.
    9. Burgess, Diana Jill & Crowley-Matoka, Megan & Phelan, Sean & Dovidio, John F. & Kerns, Robert & Roth, Craig & Saha, Somnath & van Ryn, Michelle, 2008. "Patient race and physicians' decisions to prescribe opioids for chronic low back pain," Social Science & Medicine, Elsevier, vol. 67(11), pages 1852-1860, December.
    10. Karolina Agur & Gary McLean & Kate Hunt & Bruce Guthrie & Stewart W. Mercer, 2016. "How Does Sex Influence Multimorbidity? Secondary Analysis of a Large Nationally Representative Dataset," IJERPH, MDPI, vol. 13(4), pages 1-12, March.
    11. Perelman, Julian & Mateus, Céu & Fernandes, Ana, 2010. "Gender equity in treatment for cardiac heart disease in Portugal," Social Science & Medicine, Elsevier, vol. 71(1), pages 25-29, July.
    12. Wagner, Brandon G. & Cleland, Kelly & Batur, Pelin & Wu, Justine & Rothberg, Michael B., 2019. "Emergency contraception: Links between providers' counseling choices, prescribing behaviors, and sociopolitical context," Social Science & Medicine, Elsevier, vol. 242(C).
    13. Chiarello, Elizabeth, 2013. "How organizational context affects bioethical decision-making: Pharmacists' management of gatekeeping processes in retail and hospital settings," Social Science & Medicine, Elsevier, vol. 98(C), pages 319-329.
    14. Kelly-Irving, Michelle & Delpierre, Cyrille & Schieber, Anne-Cécile & Lepage, Benoit & Rolland, Christine & Afrité, Anissa & Pascal, Jean & Cases, Chantal & Lombrail, Pierre & Lang, Thierry, 2011. "Do general practitioners overestimate the health of their patients with lower education?," Social Science & Medicine, Elsevier, vol. 73(9), pages 1416-1421.
    15. Dovidio, John F. & Penner, Louis A. & Albrecht, Terrance L. & Norton, Wynne E. & Gaertner, Samuel L. & Shelton, J. Nicole, 2008. "Disparities and distrust: The implications of psychological processes for understanding racial disparities in health and health care," Social Science & Medicine, Elsevier, vol. 67(3), pages 478-486, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lahelma, Eero & Laaksonen, Mikko & Martikainen, Pekka & Rahkonen, Ossi & Sarlio-Lähteenkorva, Sirpa, 2006. "Multiple measures of socioeconomic circumstances and common mental disorders," Social Science & Medicine, Elsevier, vol. 63(5), pages 1383-1399, September.
    2. Duffy, Katie & Connolly, Sheelah & Maitre, Bertrand & Anne Nolan, 2022. "Unequal chances? Inequalities in mortality in Ireland," Research Series, Economic and Social Research Institute (ESRI), number RS145.
    3. Garthwaite, Kayleigh & Bambra, Clare, 2017. "“How the other half live”: Lay perspectives on health inequalities in an age of austerity," Social Science & Medicine, Elsevier, vol. 187(C), pages 268-275.
    4. Huang, Nicole & Chou, Yiing-Jenq & Hu, Hsiao-Yun & Lee, Cheng-Hua, 2013. "Gender disparities in AMI management and outcomes among health professionals, their relatives, and non-health professionals in Taiwan from 1997 to 2007," Social Science & Medicine, Elsevier, vol. 77(C), pages 70-74.
    5. Thorpe Jr., Roland J. & Brandon, Dwayne T. & LaVeist, Thomas A., 2008. "Social context as an explanation for race disparities in hypertension: Findings from the Exploring Health Disparities in Integrated Communities (EHDIC) Study," Social Science & Medicine, Elsevier, vol. 67(10), pages 1604-1611, November.
    6. Shimazu, Akihito & de Jonge, Jan, 2009. "Reciprocal relations between effort-reward imbalance at work and adverse health: A three-wave panel survey," Social Science & Medicine, Elsevier, vol. 68(1), pages 60-68, January.
    7. Fujishiro, Kaori & Xu, Jun & Gong, Fang, 2010. "What does "occupation" represent as an indicator of socioeconomic status?: Exploring occupational prestige and health," Social Science & Medicine, Elsevier, vol. 71(12), pages 2100-2107, December.
    8. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    9. Drydakis, Nick, 2015. "The effect of unemployment on self-reported health and mental health in Greece from 2008 to 2013: A longitudinal study before and during the financial crisis," Social Science & Medicine, Elsevier, vol. 128(C), pages 43-51.
    10. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
    11. Karmakar, Sunita D. & Breslin, F. Curtis, 2008. "The role of educational level and job characteristics on the health of young adults," Social Science & Medicine, Elsevier, vol. 66(9), pages 2011-2022, May.
    12. S. Wouters & N. Exel & M. Donk & K. Rohde & W. Brouwer, 2015. "Do people desire to be healthier than other people? A short note on positional concerns for health," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 47-54, January.
    13. Netta Achdut & Tehila Refaeli & Talia Meital Schwartz Tayri, 2021. "Subjective Poverty, Material Deprivation Indices and Psychological Distress Among Young Adults: The Mediating Role of Social Capital and Usage of Online Social Networks," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 158(3), pages 863-887, December.
    14. Bo Kyong Seo & In Hyee Hwang & Yi Sun & Juan Chen, 2022. "Homeownership, Depression, and Life Satisfaction in China: The Gender and Urban-Rural Disparities," IJERPH, MDPI, vol. 19(22), pages 1-13, November.
    15. West, Patrick & Sweeting, Helen & Young, Robert & Kelly, Shona, 2010. "The relative importance of family socioeconomic status and school-based peer hierarchies for morning cortisol in youth: An exporatory study," Social Science & Medicine, Elsevier, vol. 70(8), pages 1246-1253, April.
    16. Frohlich, Katherine L. & Ross, Nancy & Richmond, Chantelle, 2006. "Health disparities in Canada today: Some evidence and a theoretical framework," Health Policy, Elsevier, vol. 79(2-3), pages 132-143, December.
    17. Pollock, Anne & Jones, David S., 2015. "Coronary artery disease and the contours of pharmaceuticalization," Social Science & Medicine, Elsevier, vol. 131(C), pages 221-227.
    18. Abid A. Burki & Mushtaq A. Khan & Sobia Malik, 2015. "From Chronic Disease to Food Poverty: Evidence from Pakistan," The Pakistan Development Review, Pakistan Institute of Development Economics, vol. 54(1), pages 17-33.
    19. Nazeem Muhajarine & Ronald Labonte & Allison Williams & James Randall, 2008. "Person, Perception, and Place: What Matters to Health and Quality of Life," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 85(1), pages 53-80, January.
    20. Macintyre, Sally & McKay, Laura & Ellaway, Anne, 2005. "Are rich people or poor people more likely to be ill? Lay perceptions, by social class and neighbourhood, of inequalities in health," Social Science & Medicine, Elsevier, vol. 60(2), pages 313-317, January.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:62:y:2006:i:1:p:103-115. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.