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

Soc Sci Med. 2016 Jul:161:64-73. doi: 10.1016/j.socscimed.2016.05.039. Epub 2016 May 26.

Abstract

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.

Keywords: Ethnicity; Factorial survey; Health care disparities; Immigration; Migration; Physicians’ attitudes; Residence permit status; Social rationing; Switzerland.

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Binomial Distribution
  • Choice Behavior*
  • Communication Barriers
  • Emigrants and Immigrants*
  • Female
  • General Practitioners / psychology*
  • Healthcare Disparities / ethnology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Switzerland / ethnology
  • Time Factors
  • Triage / methods