The influence of patients' immigration background and residence permit status on treatment decisions in health care. Results of a factorial survey among general practitioners in Switzerland.
This study examines the influence of patients' immigration background and residence permit status on physicians' willingness to treat patients in due time. A factorial survey was conducted among 352 general practitioners with a background in internal medicine in a German-speaking region in Switzerland. Participants expressed their self-rating (SR) as well as the expected colleague-rating (CR) to provide immediate treatment to 12 fictive vignette patients. The effects of the vignette variables were analysed using random-effects models. The results show that SR as well as CR was not only influenced by the medical condition or the physicians' time pressure, but also by social factors such as the ethnicity and migration history, the residence permit status, and the economic condition of the patients. Our findings can be useful for the development of adequate, practically relevant teaching and training materials with the ultimate aim to reduce unjustified discrimination or social rationing in health care.
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland. Electronic address: daniel.drewniak@ethik.uzh.ch.
Daniel
D
Drewniak
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland; Clinical Ethics, University Hospital Zurich, c/o Dermatologische Klinik, Gloriastrasse 31, 8091 Zurich, Switzerland. Electronic address: tanja.krones@usz.ch.
Tanja
T
Krones
Faculty of Sociology, University of Bielefeld, P.O. Box 100131, 33501 Bielefeld, Germany. Electronic address: carsten.sauer@uni-bielefeld.de.
Carsten
C
Sauer
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland; Philosophy Department, Ludwig-Maximilians-University Munich, Geschwister-Scholl-Platz 1, 80539 Munich, Germany. Electronic address: wild@ethik.uzh.ch.
Verina
V
Wild
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D016010:Binomial Distribution; D002755:Choice Behavior; D003144:Communication Barriers; D054242:Emigrants and Immigrants; D005260:Female; D058005:General Practitioners / Q000523:psychology*; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000208:ethnology; D013997:Time Factors; D014218:Triage / Q000379:methods
Ethnicity; Factorial survey; Health care disparities; Immigration; Migration; Physicians’ attitudes; Residence permit status; Social rationing; Switzerland