title: Is therapeutic judgement influenced by the patient's socio-economic status? A factorial vignette survey.
abstract: Background In Denmark patients are entitled to rehabilitation regardless of socio-economic status (SES). During this process therapists have to balance cost effectiveness with providing equal treatment. Aim To investigate whether occupational therapists and physiotherapists were influenced by the patient's SES. Material and method An experimental factorial vignette survey was used. Four different vignettes describing fictitious patient cases with different SES variables were randomly allocated to therapists working in somatic hospitals. Thereafter, the therapists judged specific clinical situations and general attitudes in relation to the patient's SES. Chi-square was used to test the statistical association between the variables. Results No statistically significant associations were found between the specific clinical situations and the patient's SES. A statistical significant association was found between general attitudes and the patient's SES. Subgroup analysis revealed a statistically significant association between the therapist's gender, age, and the therapeutic judgement in relation to SES. Conclusion In the specific clinical situations, Danish therapists seem to maintain their professional ethical principles, although they might face ethical dilemmas during their clinical decision-making. In order to prevent and resolve these dilemmas, they have to be made explicit. However, further research on how SES influences the health care professional's judgement is warranted.
authors.affiliation: a Department of Occupational Therapy , Institute of Physiotherapy and Occupational Therapy, Metropolitan University College , Copenhagen , Denmark.
authors.forename: Esben Elholm
authors.initials: EE
authors.lastname: Madsen
authors.affiliation: a Department of Occupational Therapy , Institute of Physiotherapy and Occupational Therapy, Metropolitan University College , Copenhagen , Denmark.
authors.forename: Anne-Le
authors.initials: AL
authors.lastname: Morville
authors.affiliation: a Department of Occupational Therapy , Institute of Physiotherapy and Occupational Therapy, Metropolitan University College , Copenhagen , Denmark.
authors.forename: Anette Enemark
authors.initials: AE
authors.lastname: Larsen
authors.affiliation: a Department of Occupational Therapy , Institute of Physiotherapy and Occupational Therapy, Metropolitan University College , Copenhagen , Denmark.
authors.forename: Tina
authors.initials: T
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001291:Attitude of Health Personnel; D000066491:Clinical Decision-Making / Q000941:ethics*; D003718:Denmark; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000941:ethics* / Q000523:psychology; D026761:Physical Therapy Specialty / Q000941:ethics*; D011369:Professional-Patient Relations; D012923:Social Class; D000071939:Stroke Rehabilitation / Q000941:ethics; D055815:Young Adult
keywords: Clinical decision-making; ethical behaviour; health care system; prioritization; unequal treatment