Socioeconomic differences in experiences with treatment of coronary heart disease: a qualitative study from the perspective of elderly patients

Schröder, Sara Lena; Fink, Astrid; Richter, Michael

doi:10.1136/bmjopen-2018-024151

Cited by 17 publications

(23 citation statements)

References 35 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The poorest women have the lowest utilization of health care facilities for childbirth. This is in line with the results of recent research in several countries that take the theme of socioeconomic disparity, namely in Zimbabwe (20), China (21), Spain (22), Germany (23), and USA (24)(25) (26).…”

Section: Discussionsupporting

confidence: 91%

Socioeconomic Disparities of Facility-Based Childbirth in Indonesia

Laksono,

Paramita,

Wulandari

2019

Preprint

View full text Add to dashboard Cite

Background: In Indonesia, only 74% of women give birth in health care facilities. This study was conducted to analyze the socioeconomic disparities of facilities-based childbirth in Indonesia.Methods: The analysis in this study uses raw data from the 2017 Indonesia Demographic and Health Survey (IDHS). With stratification and multistage random sampling, 17,769 women aged 15-49 years with live births in the last 5 years were sampled. Data were analyzed using a Binary Logistic Regression test.Results: Poorer women were 1.898 times more likely to use healthcare facilities for delivery than poorest women. Middle women were 2.669 times more likely to use healthcare facilities for delivery than poorest women. Richer women have 3.163 times more opportunities to use healthcare facilities for delivery than poorest women. The richest women were 6.566 times more likely to use healthcare facilities for delivery than the poorest women. Women who live in urban areas were 2.412 times more likely to use healthcare facilities for delivery than those who live in rural areas. Age, parity, level of education, ownership of health insurance, knowledge of the danger signs of pregnancy, and antenatal care, in maternity women the past five years significantly contribute to the utilization of healthcare facilities for delivery.Conclusion: There was a significant disparity between socioeconomic in utilizing healthcare facilities for delivery in Indonesia. Women with better socioeconomic status have better possibilities for utilizing healthcare facilities for delivery.

show abstract

Section: Discussionsupporting

confidence: 91%

Socioeconomic Disparities of Facility-Based Childbirth in Indonesia

Laksono,

Paramita,

Wulandari

2019

Preprint

View full text Add to dashboard Cite

show abstract

“…As a consequence, the lower educated might feel less exposed to existing communication problems (language barriers, terminology, information gap) [ 72 ] with their longtime, well-known primary-care physicians, and they might prefer visits to them compared to specialist physicians [ 10 ]. The perceived role in healthcare varies between SES groups, as those with low SES tend to delegate responsibility to healthcare professionals [ 73 ]. Given the trustful and longtime relationship with primary care physicians compared to specialists, and given that primary-care physicians have the task of gatekeeping in some countries, might emphasize the importance of primary-care physicians from the perspective of the low-SES population when delegating responsibility for their healthcare, and might therefore explain the more frequent visits from the most deprived.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review

Lueckmann

Hoebel

Roick

et al. 2021

Int J Equity Health

Self Cite

View full text Add to dashboard Cite

Background Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. Methods We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. Results Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. Conclusion This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare. PROSPERO registration number CRD42019123222.

show abstract

“…In their study they found that patients of lower SES are less likely to participate in shared decision making and ask questions [ 66 ]. Schroder et al [ 67 ] pointed out that patients in the bottom socioeconomic quartile had less medical knowledge and were less likely to desire to play an active role in their disease management than patients in the highest quartile. Studies by Wright et al [ 30 ] and Okoroafor et al [ 31 ] demonstrated that patients were more likely to report high levels of anxiety and depression in worse social deprivation indexes, and Tyser et al [ 58 ] and Tisano et al [ 68 ] independently showed that patients with worse PROMIS anxiety and depression scores were less likely to report satisfaction on the PGOMPS.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the impact of social deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Stephens

Potter

Tyser

et al. 2021

Health Qual Life Outcomes

View full text Add to dashboard Cite

Background Social deprivation has been shown to affect access to health care services, and influences outcomes for a variety of physical and psychological conditions. However, the impact on patient satisfaction remains less clear. The objective of this study was to determine if social deprivation is an independent predictor of patient satisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey (PGOMPS). Methods We retrospectively reviewed unique new adult patient (≥ 18 years of age) seen at a tertiary academic hospital and rural/urban outreach hospitals/clinics between January 2014 and December 2017. Satisfaction was defined a priori as achieving a score above the 33rd percentile. The 2015 Area Deprivation Index (ADI) was used to determine social deprivation (lower score signifies less social deprivation). Univariate and multivariable binary logistic regression were used to determine the impact of ADI on PGOMPS total and provider sub-scores while controlling for variables previously shown to impact scores (wait time, patient age, sex, race, specialty type, provider type, and insurance status). Results Univariate analysis of PGOMPS total scores revealed a 4% decrease in odds of patient satisfaction per decile increase in ADI (p < 0.001). Patients within the most deprived quartile were significantly less likely to report satisfaction compared to the least deprived quartile (OR 0.79, p < 0.001). Multivariable analysis revealed that the odds of achieving satisfaction decreased 2% for each decile increase in ADI on the Total Score (p < 0.001), independent of other variables previously shown to impact scores. For PGOMPS Provider Sub-Score, univariate analysis showed that patients in the lowest ADI quartile were significantly less likely be satisfied, as compared to the least deprived quartile (OR 0.77; 95% CI 0.70–0.86; p < 0.001). A 5% decrease in a patient being satisfied was observed for each decile increase in ADI (OR 0.95; 95% CI 0.94–0.96; p < 0.001). Conclusions Social deprivation was an independent predictor of outpatient visit dissatisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey. These results necessitate consideration when developing health care delivery policies that serve to minimize inequalities between patients of differing socioeconomic groups.

show abstract

Socioeconomic differences in experiences with treatment of coronary heart disease: a qualitative study from the perspective of elderly patients

Cited by 17 publications

References 35 publications

Socioeconomic Disparities of Facility-Based Childbirth in Indonesia

Socioeconomic Disparities of Facility-Based Childbirth in Indonesia

Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review

Evaluating the impact of social deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Contact Info

Product

Resources

About