Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD100E, Indianapolis, IN, 46202, USA.
J Behav Med. 2021 Oct;44(5):662-672. doi: 10.1007/s10865-021-00224-y. Epub 2021 Apr 16.
To determine the effect of patient immigrant status on physician trainees' diabetes treatment decisions. Participants were 140 physician trainees ('providers'). Providers viewed videos and vignettes of virtual patients differing in immigrant status (born in Mexico or U.S.; other characteristics held constant). Analyses were completed at the group and individual levels. Providers were less likely to refer foreign-born (vs. U.S.-born) patients to endocrinology. Individual-level results showed an almost even split between treatment ratings for foreign-born vs. U.S.-born patients for three decisions (take no action, add oral hypoglycemic agent, add/switch to insulin), explaining why group-level differences for these ratings did not emerge (i.e., they were cancelled out). Physician trainees are less likely to refer foreign-born patients to endocrinology. Half of individual-level decisions were influenced by patient immigrant status, but group-level analyses mask these differences. Systematic treatment differences based on non-relevant factors could lead to adverse outcomes for immigrants.
为了确定患者移民身份对医师受训者糖尿病治疗决策的影响。参与者为 140 名医师受训者（“提供者”）。提供者观看了虚拟患者的视频和小插曲，这些患者在移民身份上存在差异（出生于墨西哥或美国；其他特征保持不变）。分析在群体和个体水平上完成。提供者不太可能将外国出生的（与美国出生的）患者转介到内分泌科。个体水平的结果显示，对于三个决策（不采取行动、添加口服降糖药、添加/转换为胰岛素），外国出生的患者的治疗评分几乎平分秋色，这解释了为什么这些评分的群体水平差异没有出现（即，它们相互抵消）。医师受训者不太可能将外国出生的患者转介到内分泌科。一半的个体决策受到患者移民身份的影响，但群体水平的分析掩盖了这些差异。基于不相关因素的系统治疗差异可能会对移民造成不利后果。
