TY - JOUR
T1 - Factors Related to Physician Clinical Decision-Making for African-American and Hispanic Patients
T2 - a Qualitative Meta-Synthesis
AU - Breathett, Khadijah
AU - Jones, Jacqueline
AU - Lum, Hillary D.
AU - Koonkongsatian, Dawn
AU - Jones, Christine D.
AU - Sanghvi, Urvi
AU - Hoffecker, Lilian
AU - McEwen, Marylyn
AU - Daugherty, Stacie L.
AU - Blair, Irene V.
AU - Calhoun, Elizabeth
AU - de Groot, Esther
AU - Sweitzer, Nancy K.
AU - Peterson, Pamela N.
N1 - Funding Information:
Funding information Dr. Breathett received support from the American Heart Association (AHA) Strategically Focused Research Network (no. 16SFRN29640000), the National Institute of Health (NIH L60 MD010857), the University of Colorado Department of Medicine, Health Services Research Development Grant Award, and the University of Arizona Health Sciences, Strategic Priorities Faculty Initiative Grant. Dr. Jones received support from the Agency for Healthcare Research and Quality (K08HS024569). Dr. Peterson discloses grant funding from the AHA. Otherwise there are no disclosures.
Publisher Copyright:
© 2018, W. Montague Cobb-NMA Health Institute.
PY - 2018/12/15
Y1 - 2018/12/15
N2 - Clinical decision-making may have a role in racial and ethnic disparities in healthcare but has not been evaluated systematically. The purpose of this study was to synthesize qualitative studies that explore various aspects of how a patient’s African-American race or Hispanic ethnicity may factor into physician clinical decision-making. Using Ovid MEDLINE, Embase, and Cochrane Library, we identified 13 manuscripts that met inclusion criteria of usage of qualitative methods; addressed US physician clinical decision-making factors when caring for African-American, Hispanic, or Caucasian patients; and published between 2000 and 2017. We derived six fundamental themes that detail the role of patient race and ethnicity on physician decision-making, including importance of race, patient-level issues, system-level issues, bias and racism, patient values, and communication. In conclusion, a non-hierarchical system of intertwining themes influenced clinical decision-making among racial and ethnic minority patients. Future study should systematically intervene upon each theme in order to promote equitable clinical decision-making among diverse racial/ethnic patients.
AB - Clinical decision-making may have a role in racial and ethnic disparities in healthcare but has not been evaluated systematically. The purpose of this study was to synthesize qualitative studies that explore various aspects of how a patient’s African-American race or Hispanic ethnicity may factor into physician clinical decision-making. Using Ovid MEDLINE, Embase, and Cochrane Library, we identified 13 manuscripts that met inclusion criteria of usage of qualitative methods; addressed US physician clinical decision-making factors when caring for African-American, Hispanic, or Caucasian patients; and published between 2000 and 2017. We derived six fundamental themes that detail the role of patient race and ethnicity on physician decision-making, including importance of race, patient-level issues, system-level issues, bias and racism, patient values, and communication. In conclusion, a non-hierarchical system of intertwining themes influenced clinical decision-making among racial and ethnic minority patients. Future study should systematically intervene upon each theme in order to promote equitable clinical decision-making among diverse racial/ethnic patients.
KW - Bias
KW - Clinical decision-making
KW - Healthcare disparities
KW - Minority health
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U2 - 10.1007/s40615-018-0468-z
DO - 10.1007/s40615-018-0468-z
M3 - Article
C2 - 29508374
AN - SCOPUS:85045153437
VL - 5
SP - 1215
EP - 1229
JO - Journal of racial and ethnic health disparities
JF - Journal of racial and ethnic health disparities
SN - 2197-3792
IS - 6
ER -