Ethnic inequities in the patterns of personalized care adjustments for 'informed dissent' and 'patient unsuitable' : a retrospective study using Clinical Practice Research Datalink
© The Author(s) 2023. Published by Oxford University Press on behalf of Faculty of Public Health..
BACKGROUND: In England, general practitioners voluntarily take part in the Quality and Outcomes Framework, which is a program that seeks to improve care by rewarding good practice. They can make personalized care adjustments (PCAs), e.g. if patients choose not to have the treatment/intervention offered ('informed dissent') or because they are considered to be clinically 'unsuitable'.
METHODS: Using data from the Clinical Practice Research Datalink (Aurum), this study examined patterns of PCA reporting for 'informed dissent' and 'patient unsuitable', how they vary across ethnic groups and whether ethnic inequities were explained by sociodemographic factors or co-morbidities.
RESULTS: The odds of having a PCA record for 'informed dissent' were lower for 7 of the 10 minoritized ethnic groups studied. Indian patients were less likely than white patients to have a PCA record for 'patient unsuitable'. The higher likelihood of reporting for 'patient unsuitable' among people from Black Caribbean, Black Other, Pakistani and other ethnic groups was explained by co-morbidities and/or area-level deprivation.
CONCLUSIONS: The findings counter narratives that suggest that people from minoritized ethnic groups often refuse medical intervention/treatment. The findings also illustrate ethnic inequities in PCA reporting for 'patient unsuitable', which are linked to clinical and social complexity and should be tackled to improve health outcomes for all.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
Journal of public health (Oxford, England) - 45(2023), 4 vom: 29. Nov., Seite e692-e701 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hayanga, Brenda [VerfasserIn] |
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| Links: |
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| Themen: |
Ethnicity |
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| Anmerkungen: |
Date Completed 04.12.2023 Date Revised 24.04.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/pubmed/fdad104 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM359351670 |
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| 245 | 1 | 0 | |a Ethnic inequities in the patterns of personalized care adjustments for 'informed dissent' and 'patient unsuitable' |b a retrospective study using Clinical Practice Research Datalink |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 24.04.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of Faculty of Public Health. | ||
| 520 | |a BACKGROUND: In England, general practitioners voluntarily take part in the Quality and Outcomes Framework, which is a program that seeks to improve care by rewarding good practice. They can make personalized care adjustments (PCAs), e.g. if patients choose not to have the treatment/intervention offered ('informed dissent') or because they are considered to be clinically 'unsuitable' | ||
| 520 | |a METHODS: Using data from the Clinical Practice Research Datalink (Aurum), this study examined patterns of PCA reporting for 'informed dissent' and 'patient unsuitable', how they vary across ethnic groups and whether ethnic inequities were explained by sociodemographic factors or co-morbidities | ||
| 520 | |a RESULTS: The odds of having a PCA record for 'informed dissent' were lower for 7 of the 10 minoritized ethnic groups studied. Indian patients were less likely than white patients to have a PCA record for 'patient unsuitable'. The higher likelihood of reporting for 'patient unsuitable' among people from Black Caribbean, Black Other, Pakistani and other ethnic groups was explained by co-morbidities and/or area-level deprivation | ||
| 520 | |a CONCLUSIONS: The findings counter narratives that suggest that people from minoritized ethnic groups often refuse medical intervention/treatment. The findings also illustrate ethnic inequities in PCA reporting for 'patient unsuitable', which are linked to clinical and social complexity and should be tackled to improve health outcomes for all | ||
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| 700 | 1 | |a Ashworth, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Hughes, Jay |e verfasserin |4 aut | |
| 700 | 1 | |a Bécares, Laia |e verfasserin |4 aut | |
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