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Cited by 37Migration, Identity, and HealthCultural Competency in Health CareMigration, Health and Trauma

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

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Drewniak, Daniel, Krones, Tanja, Sauer, Carsten, Wild, Verina·2016·Social Science & Medicine
DOI 10.1016/j.socscimed.2016.05.039
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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.

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  • A recent vignette study in Switzerland found that in the German-speaking part of the country, physicians displayed negative bias in treatment decisions towards fictional Serbian patients.

    “a recent vignette study in Switzerland found that in the German-speaking part of the country, physicians displayed negative bias in treatment decisions towards fictional Serbian patients (skin colour was unspecified, but it would typically be assumed to be white), but no significant negative bias towards fictional patients from Ghana (skin colour would be assumed to be black) [18].”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [18]

    The study participants were general practitioners in Zurich (Section 3.4), and Serbian vignettes received significantly lower quick-treatment ratings in both physicians’ self-ratings and their ratings of colleagues (Section 5.3). The citing sentence’s broader claim of no significant negative bias toward Ghanaian patients omits a significant negative effect in colleague-ratings. The study varied patient origin, not skin colour, so the parenthetical assumptions about skin colour were not tested (vignette table). (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • The same Swiss vignette study found no significant negative bias towards fictional patients from Ghana.

    “a recent vignette study in Switzerland found that in the German-speaking part of the country, physicians displayed negative bias in treatment decisions towards fictional Serbian patients (skin colour was unspecified, but it would typically be assumed to be white), but no significant negative bias towards fictional patients from Ghana (skin colour would be assumed to be black) [18].”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [18]

    Section 5.3 (Social factors) reports no significant decrease for patients from Ghana in physicians’ self-ratings (p = 0.257), but a significant decrease in their ratings of colleagues’ treatment decisions (p < 0.001). The unqualified claim of no significant negative bias omits that second result. (LLM, conf=0.92)

    Experimental — accuracy not yet measured

  • Race understood as white/black is not the source of the most potentially harmful stereotypes and disparities in all cultural contexts.

    “It is important to include studies conducted in non-US countries because race understood as white/black is not the source of the most potentially harmful stereotypes and disparities in all cultural contexts.”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [18]

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Cited by

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Authors
Drewniak, D., Krones, T., Sauer, C., & Wild, V.
Affiliations
  • University of Zurich (CH)
  • Bielefeld University (DE)
Corresponding author
Wild, Verina
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2016-07
Volume
161
Pages
64-73
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2016.05.039
OpenAlex
W2403362623
Cited by
37
References
7
Citations by year
2026: 2 · 2025: 1 · 2024: 7 · 2023: 4 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 2 · 2017: 6 · 2016: 1
FWCI
10.49
Type
journal article
Language
en
Open access
Licence
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • OPUS (Augsburg University) (submittedVersion, cc-by-nc-nd)
  • RePEc: Research Papers in Economics (submittedVersion)
  • PUB – Publications at Bielefeld University (Bielefeld University) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Funders
University of Zurich, Switzerland
Topics
  • Social Sciences › Sociology and Political Science › Migration, Identity, and Health
  • Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords
migration background, general practitioners, health care discrimination, ethnicity, migration history, vignette study, time pressure, medical education
MeSH terms
Adult, Aged, Attitude of Health Personnel, Choice Behavior, Communication Barriers, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Socioeconomic Factors, Switzerland, Time Factors, Triage, Multivariate Analysis, Binomial Distribution, Logistic Models, Emigrants and Immigrants, Healthcare Disparities, General Practitioners

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