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Do general practitioners overestimate the health of their patients with lower education?

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  • Kelly-Irving, Michelle
  • Delpierre, Cyrille
  • Schieber, Anne-Cécile
  • Lepage, Benoit
  • Rolland, Christine
  • Afrité, Anissa
  • Pascal, Jean
  • Cases, Chantal
  • Lombrail, Pierre
  • Lang, Thierry

Abstract

This study sought to ascertain whether disagreement between patients and physicians on the patients’ health status varies according to patients’ education level. INTERMEDE is a cross-sectional multicentre study. Data were collected from both patients and doctors via pre- and post consultation questionnaires at the GP’s office over a two-week period in October 2007 in 3 regions of France. The sample consists of 585 eligible patients (61% women) and 27 GPs. A significant association between agreement/disagreement between GP and patient on the patient’s health status and patient’s education level was observed: 75% of patients with a high education level agreed with their GP compared to 50% of patients with a low level of education. Patients and GPs disagreed where patients with the lowest education level said that their health was worse relative to their doctor’s evaluation 37% of the time, versus 16% and 14% for those with a medium or high education level respectively. A multilevel multivariate analysis revealed that patients with a low educational level and medium educational level respectively were at higher risk of being overestimated by GP’s in respect of self-reported health even if controlling for confounders. These findings suggest that people with a lower education level who consider themselves to have poor health are less reliably identified as such in the primary care system. This could potentially result in lack of advice and treatment for these patients and ultimately the maintenance of health inequalities.

Suggested Citation

  • 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.
  • Handle: RePEc:eee:socmed:v:73:y:2011:i:9:p:1416-1421
    DOI: 10.1016/j.socscimed.2011.07.031
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    References listed on IDEAS

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    1. Street Jr., Richard L. & Gordon, Howard & Haidet, Paul, 2007. "Physicians' communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?," Social Science & Medicine, Elsevier, vol. 65(3), pages 586-598, August.
    2. Ariss, Steven M., 2009. "Asymmetrical knowledge claims in general practice consultations with frequently attending patients: Limitations and opportunities for patient participation," Social Science & Medicine, Elsevier, vol. 69(6), pages 908-919, September.
    3. 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.
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    Cited by:

    1. Martin Siegel & Andreas Mielck & Werner Maier, 2015. "Individual Income, Area Deprivation, and Health: Do Income‐Related Health Inequalities Vary by Small Area Deprivation?," Health Economics, John Wiley & Sons, Ltd., vol. 24(11), pages 1523-1530, November.
    2. Setti Rais Ali & Paul Dourgnon & Lise Rochaix, 2018. "Social Capital or Education: What Matters Most to Cut Time to Diagnosis?," Working Papers halshs-01703170, HAL.
    3. Martin Siegel & Markus Luengen & Stephanie Stock, 2013. "On age-specific variations in income-related inequalities in diabetes, hypertension and obesity," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(1), pages 33-41, February.

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