Drewniak Daniel, Krones Tanja, Sauer Carsten, Wild Verina
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland.
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.
Soc Sci Med. 2016 Jul;161:64-73. doi: 10.1016/j.socscimed.2016.05.039. Epub 2016 May 26.
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.
本研究考察了患者的移民背景和居住许可状况对医生及时治疗患者意愿的影响。在瑞士德语区对352名具有内科背景的全科医生进行了一项析因调查。参与者对12名虚拟病例患者进行即时治疗给出了自我评分（SR）以及预期的同事评分（CR）。使用随机效应模型分析了病例变量的影响。结果表明，自我评分以及同事评分不仅受到医疗状况或医生时间压力的影响，还受到社会因素的影响，如患者的种族和移民历史、居住许可状况以及经济状况。我们的研究结果对于开发适当的、具有实际相关性的教学和培训材料可能是有用的，最终目的是减少医疗保健中不合理的歧视或社会配给。
