Chatelard Sophia, Bodenmann Patrick, Vaucher Paul, Herzig Lilli, Bischoff Thomas, Burnand Bernard
Department of General Practice, University Joseph Fourier, Grenoble, France.
Vulnerable Population Unit, Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
PLoS One. 2014 Jan 15;9(1):e84828. doi: 10.1371/journal.pone.0084828. eCollection 2014.
To identify which physician and patient characteristics are associated with physicians' estimation of their patient social status.
Cross-sectional multicentric survey.
Fourty-seven primary care private offices in Western Switzerland.
Random sample of 2030 patients ≥ 16, who encountered a general practitioner (GP) between September 2010 and February 2011.
patient social status perceived by GPs, using the MacArthur Scale of Subjective Social Status, ranging from the bottom (0) to the top (10) of the social scale.Secondary outcome: Difference between GP's evaluation and patient's own evaluation of their social status. Potential patient correlates: material and social deprivation using the DiPCare-Q, health status using the EQ-5D, sources of income, and level of education. GP characteristics: opinion regarding patients' deprivation and its influence on health and care.
To evaluate patient social status, GPs considered the material, social, and health aspects of deprivation, along with education level, and amount and type of income. GPs declaring a frequent reflexive consideration of their own prejudice towards deprived patients, gave a higher estimation of patients' social status (+1.0, p = 0.002). Choosing a less costly treatment for deprived patients was associated with a lower estimation (-0.7, p = 0.002). GP's evaluation of patient social status was 0.5 point higher than the patient's own estimate (p<0.0001).
GPs can perceive the various dimensions of patient social status, although heterogeneously, according partly to their own characteristics. Compared to patients' own evaluation, GPs overestimate patient social status.
确定哪些医生和患者特征与医生对患者社会地位的评估相关。
横断面多中心调查。
瑞士西部的47个初级保健私人诊所。
2030名年龄≥16岁患者的随机样本，这些患者在2010年9月至2011年2月期间看过全科医生（GP）。
全科医生所感知的患者社会地位，使用麦克阿瑟主观社会地位量表，范围从社会等级的底层（0）到顶层（10）。次要结果：全科医生对患者社会地位的评估与患者自身评估之间的差异。潜在的患者相关因素：使用DiPCare-Q量表评估物质和社会剥夺情况，使用EQ-5D量表评估健康状况，收入来源和教育水平。全科医生特征：对患者剥夺情况及其对健康和护理影响的看法。
为评估患者社会地位，全科医生考虑了剥夺的物质、社会和健康方面，以及教育水平、收入数量和类型。宣称经常反思自己对贫困患者偏见的全科医生，对患者社会地位的评估更高（+1.0，p = 0.002）。为贫困患者选择成本较低的治疗方法与较低的评估相关（-0.7，p = 0.002）。全科医生对患者社会地位的评估比患者自己的估计高0.5分（p<0.0001）。
全科医生能够感知患者社会地位的各个维度，尽管存在异质性，部分取决于他们自身的特征。与患者自己的评估相比，全科医生高估了患者的社会地位。
