RT Journal Article
SR Electronic
T1 Routinely asking patients about income in primary care: a mixed-methods study
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2021.0090
DO 10.3399/BJGPO.2021.0090
A1 Andrew David Pinto
A1 Erica Shenfeld
A1 Tatiana Aratangy
A1 Ri Wang
A1 Rosane Nisenbaum
A1 Aisha Lofters
A1 Gary Bloch
A1 Tara Kiran
YR 2021
UL http://bjgpopen.org/content/early/2021/10/19/BJGPO.2021.0090.abstract
AB Background Income is a key social determinant of health yet it is rare for data on income to be routinely collected and integrated with electronic health records.Aim To examine response bias and evaluate patient perspectives of being asked about income in primary care.Design and setting Mixed-methods study in a large, multi-site primary care organization in Toronto, Canada where patients are asked about income in a routinely administered sociodemographic survey.Methods We examined data from the electronic health records of patients who answered at least one question on the survey between December 2013 and March 2016 (n=14,247). We compared those who responded to the income question to non-responders. We also conducted structured interviews with 27 patients.Results 10,441 (73%) patients responded to both parts of the income question. Female patients, minorities, caregivers of young children and seniors were less likely to respond. From interviews, many patients were comfortable answering the income question, particularly if they understood the connection between income and health, and believed the data would be used to improve care. Several patients found it difficult to estimate their income or felt the options did not reflect fluctuating financial circumstances.Conclusions Many patients will provide data on income in the context of a survey in primary care, but accurately estimating income can be challenging. Future research should compare self-reported income to perceived financial strain. Data on income linked to health records can help identify health inequities and can help target anti-poverty interventions.