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Low Socioeconomic Status Affects Clinical Decisions

Changes based on status may contribute to measured socioeconomic disparities in health care

TUESDAY, Jan. 15 (HealthDay News) -- Low patient socioeconomic status may significantly affect clinical decision making, leading to changes in disease management that are based on the patient's best interest but also could increase disparities in health care quality, according to the results of a study published in the January/February issue of the Annals of Family Medicine.

Susannah M. Bernheim, M.D., of the Yale University School of Medicine in New Haven, Conn., and colleagues interviewed 18 primary care physicians in Connecticut, including six women and 12 from ethnic minorities.

The researchers found that physicians disagreed about the effect of socioeconomic status on clinical management. Although the physicians stated that management changes based on socioeconomic status were made in the patient's interest, they differed over how these changes affected patient outcomes. The physicians also voiced concerns about the time, effort, and expense involved in developing feasible treatment plans for patients with low socioeconomic status.

"Many of the changes that physicians described -- less aggressive diabetes management, postponement of testing, or use of less than ideal or non-standard treatments as a result of financial limitations -- may contribute to observed disparities in health care quality," the authors state. "Our findings highlight the need to explore how tailoring patient care affects outcomes compared with care that is blind to socioeconomic status. These results also suggest that observed disparities may in part result from physician actions made in what they believe to be a patient's interest."

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