Is therapeutic judgement influenced by the patient’s socio-economic status? A factorial vignette
survey
Sammanfattning
Background In Denmark patients are entitled to rehabilitation regardless of socio-economic
status (SES). During this process therapists have to balance cost effectiveness with providing equal
treatment. Aim To investigate whether occupational therapists and physiotherapists were influenced
by the patient’s SES. Material and method An experimental factorial vignette survey was used. Four
different vignettes describing fictitious patient cases with different SES variables were randomly
allocated to therapists working in somatic hospitals. Thereafter, the therapists judged specific clinical
situations and general attitudes in relation to the patient’s SES. Chi-square was used to test the
statistical association between the variables. Results No statistically significant associations were
found between the specific clinical situations and the patient’s SES. A statistical significant
association was found between general attitudes and the patient’s SES. Subgroup analysis revealed
a statistically significant association between the therapist’s gender, age, and the therapeutic
judgement in relation to SES. Conclusion In the specific clinical situations, Danish therapists seem to
maintain their professional ethical principles, although they might face ethical dilemmas during their
clinical decision-making. In order to prevent and resolve these dilemmas, they have to be made
explicit. However, further research on how SES influences the health care professional’s judgement
is warranted.