Factors Related to Physician Clinical Decision-Making for African-American and Hispanic Patients: a Qualitative Meta-Synthesis

Khadijah Breathett, Jacqueline Jones, Hillary D. Lum, Dawn Koonkongsatian, Christine D. Jones, Urvi Sanghvi, Lilian Hoffecker, Marylyn McEwen, Stacie L. Daugherty, Irene V. Blair, Elizabeth Calhoun, Esther de Groot, Nancy K. Sweitzer, Pamela N. Peterson

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1215-1229
Number of pages15
JournalJournal of Racial and Ethnic Health Disparities
Volume5
Issue number6
DOIs
StatePublished - Dec 15 2018

Keywords

  • Bias
  • Clinical decision-making
  • Healthcare disparities
  • Minority health

ASJC Scopus subject areas

  • Health(social science)
  • Anthropology
  • Sociology and Political Science
  • Health Policy
  • Public Health, Environmental and Occupational Health

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    Breathett, K., Jones, J., Lum, H. D., Koonkongsatian, D., Jones, C. D., Sanghvi, U., Hoffecker, L., McEwen, M., Daugherty, S. L., Blair, I. V., Calhoun, E., de Groot, E., Sweitzer, N. K., & Peterson, P. N. (2018). Factors Related to Physician Clinical Decision-Making for African-American and Hispanic Patients: a Qualitative Meta-Synthesis. Journal of Racial and Ethnic Health Disparities, 5(6), 1215-1229. https://doi.org/10.1007/s40615-018-0468-z