Dan Med J. 2021 Oct 14;68(11):A03210244.
INTRODUCTION Medical doctors in Denmark are clinically challenged by ethnic minority patients, resulting in delayed or incorrect treatments. Apart from language barriers, little is known about the nature of the challenges presented by ethnic minority patients. The present study investigated the level of agreement between the patients' main problems, doctors' referral notes and patient-reported problems documented at a hospital-based migrant health outpatient clinic. METHODS A retrospective cross-sectional study was conducted on 150 patients referred to the Migrant Health Clinic (MHC), Odense University Hospital, Denmark. The study was based on a full "Problem list" that was co-produced with the patient. Cohen's kappa (κ) and Chamberlain's proportionate positive agreement (pppa) were calculated for the medical and socioeconomic problems described in the referrals and MHC notes, respectively. RESULTS Significant agreement between patient and referring doctor was found for only two health complaints: musculoskeletal pain (κ = 0.43 and pppa = 0.69) and Type 2 diabetes mellitus (κ = 0.71 and pppa = 0.59). CONCLUSIONS Doctors and patients rarely agree on the patients' health problems. Patient engagement such as co-production of care may potentially produce the time and resources needed to help doctors identify the patients' priorities and describe them in referrals. FUNDING The Novo Nordisk Foundation granted a pregraduate scholarship to cover the salary of the corresponding author. TRIAL REGISTRATION not relevant.
简介
丹麦的医生在临床上面临少数族裔患者的挑战，导致治疗延迟或不当。除了语言障碍，对于少数族裔患者带来的挑战的性质，人们知之甚少。本研究调查了医院移民健康门诊中患者的主要问题、医生的转诊记录和患者报告的问题之间的一致性程度。
方法
对丹麦奥胡斯大学医院移民健康诊所（MHC）转诊的 150 名患者进行了回顾性横断面研究。该研究基于与患者共同生成的完整“问题清单”。分别计算了转诊和 MHC 记录中描述的医疗和社会经济问题的 Cohen's kappa（κ）和 Chamberlain 的比例阳性一致率（pppa）。
结果
肌肉骨骼疼痛（κ=0.43，pppa=0.69）和 2 型糖尿病（κ=0.71，pppa=0.59）。
结论
医生和患者很少在患者的健康问题上达成一致。患者参与，如共同制定护理计划，可能会产生医生确定患者优先级并在转诊中描述这些问题所需的时间和资源。
资金
诺和诺德基金会授予了一笔本科奖学金，以支付通讯作者的薪水。
试验注册 不相关。
