Article Figures & Data
Tables
Characteristic Value Male, No. (%) 12 (67) Age range, years 31–54 Race, No. (%) White 9 (50) Asian 6 (33) African American/black 2 (11) Other 1 (6) Ethnicity, Hispanic, No. (%) 3 (17) Patient practice, years 5–23 Patient composition, No. (%) Uninsured 0–50 Medicaid 2–70 Veterans Affairs physicians, No. (%) 2 (11) Practice setting, No. (%) Urban 13 (72) Suburban 4 (22) Rural 1 (6) Specialty, No. (%) Internists 16 (88) Family physicians 2 (11) Attributes Examples of Descriptors Used by Physicians Economic Uninsured Unemployed On welfare Sociocultural Minority race or ethnicity Low educational achievement Poor social networks Personality traits Stoic Guarded or distrustful Appreciative Life circumstances Chaotic lives Involvement with substance abuse Difficulty with transportation Attitude and knowledge about medicine Poor health literacy Noncompliant Poor health behaviors Sicker or more acute visits Interested in health Unable to characterize as a group Everyone is different No general statement about them
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The Article in Brief
Influence of Patients' Socioeconomic Status on Clinical Management Decisions: A Qualitative Study
Susannah M. Bernheim, MD, MHS , and colleagues
Background Patients' socioeconomic status (SES) has been shown to influence their health and the quality of their health care. This study looks at doctors' perspectives on how patients' SES influences the care they provide.
What This Study Found Doctors change their management plans to make care more affordable, feasible, or comprehensible for patients with low socioeconomic status. Although these changes are intended for the patient's best interest, doctors have concerns about maintaining a standard of consistent care for all patients.
Implications
- Patients� socioeconomic status affects doctors� day-to-day clinical management decisions.
- Helping patients accommodate their financial needs by altering care may contribute to differences in health care based on socioeconomic status.
- Recognizing the role of socioeconomic factors in clinical decision making may be an important contribution in developing standards to ensure high-quality care and a physician workforce willing to care for vulnerable populations.
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