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

Sophia Chatelard; Patrick Bodenmann; Paul Vaucher; Lilli Herzig; Thomas Bischoff; Bernard Burnand

doi:10.1371/journal.pone.0084828

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.

Authors

Sophia Chatelard¹, Patrick Bodenmann², Paul Vaucher³, Lilli Herzig⁴, Thomas Bischoff⁴, Bernard Burnand⁵

Affiliations

¹ Department of General Practice, University Joseph Fourier, Grenoble, France.
² Vulnerable Population Unit, Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
³ Vulnerable Population Unit, Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland ; Department of Community Medicine and Primary Care, Geneva University Hospitals, Geneva, Switzerland.
⁴ Institute of General Practice, University of Lausanne, Lausanne, Switzerland.
⁵ Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.

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

Grants and funding

There were no fundings for the present study. The Swiss Academy of Medical Science, the Department of Social Action and Health of the Canton of Vaud and the Faculty of Biology and Medicine from the University of Lausanne gave fundings for the original study on which the present article is based. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.