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Is general practitioner decision making associated with patient socio-economic status?


  • Scott, Anthony
  • Shiell, Alan
  • King, Madeleine


This paper presents a preliminary exploration into the relationship between decisions made by general practitioners (GPs) and the socio-economic status (SES) of patients. There is a large literature on the association between SES, health state and the use of health services, but relatively little has been published on the association between SES and decisions by clinicians once a patient is in the health system. The associations between GP decision making and the patient's SES, health status, gender and insurance status are examined using logit analysis. Three sets of binary choices are analysed: the decision to follow up; to prescribe; and to perform or to order a diagnostic test. Secondary data on consultations for a check up/examination were used to explore these relationships. The results suggest that SES is associated independently with the decision to test and the decision to prescribe but not with the decision to follow up. Patients of high SES are, ceteris paribus, more likely to be tested and less likely to receive a prescription compared with patients of low SES. Women are more likely to be tested and to receive a prescription than men. These findings have implications for the pursuit of equity as a goal of health services policy.

Suggested Citation

  • Scott, Anthony & Shiell, Alan & King, Madeleine, 1996. "Is general practitioner decision making associated with patient socio-economic status?," Social Science & Medicine, Elsevier, vol. 42(1), pages 35-46, January.
  • Handle: RePEc:eee:socmed:v:42:y:1996:i:1:p:35-46

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    Cited by:

    1. Fichera, Eleonora & Sutton, Matt, 2011. "State and self investments in health," Journal of Health Economics, Elsevier, vol. 30(6), pages 1164-1173.
    2. Croxson, B. & Propper, C. & Perkins, A., 2001. "Do doctors respond to financial incentives? UK family doctors and the GP fundholder scheme," Journal of Public Economics, Elsevier, vol. 79(2), pages 375-398, February.
    3. Paraponaris, A. & Verger, P. & Desquins, B. & Villani, P. & Bouvenot, G. & Rochaix, L. & Gourheux, J. C. & Moatti, J. P. AU -, 2004. "Delivering generics without regulatory incentives?: Empirical evidence from French general practitioners about willingness to prescribe international non-proprietary names," Health Policy, Elsevier, vol. 70(1), pages 23-32, October.
    4. Lutfey, Karen E. & Campbell, Stephen M. & Renfrew, Megan R. & Marceau, Lisa D. & Roland, Martin & McKinlay, John B., 2008. "How are patient characteristics relevant for physicians' clinical decision making in diabetes? An analysis of qualitative results from a cross-national factorial experiment," Social Science & Medicine, Elsevier, vol. 67(9), pages 1391-1399, November.
    5. Shiell, Alan, 1997. "Health outcomes are about choices and values: an economic perspective on the health outcomes movement," Health Policy, Elsevier, vol. 39(1), pages 5-15, January.


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