General practitioners can evaluate the material, social and health dimensions of patient social status

PLoS One. 2014 Jan 15;9(1):e84828. doi: 10.1371/journal.pone.0084828. eCollection 2014.

Abstract

Objective: To identify which physician and patient characteristics are associated with physicians' estimation of their patient social status.

Design: Cross-sectional multicentric survey.

Setting: Fourty-seven primary care private offices in Western Switzerland.

Participants: Random sample of 2030 patients ≥ 16, who encountered a general practitioner (GP) between September 2010 and February 2011.

Primary outcome: 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.

Results: 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).

Conclusions: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • General Practitioners*
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Social Class*
  • Switzerland