The impact of socioeconomic factors on patient care decisions
In the health sector, clinical decision-making addressing patient care is an essential aspect of everyday clinical practice. What is patient care? Patient care ensures that healthcare professionals keep their patients comfortable and satisfied while keeping their wellbeing in mind when providing health services. Clinical decision-making refers to how healthcare professionals make informed judgments regarding the best treatment for their patients.
Clinical decision-making can be quite difficult and tedious as there are several factors to consider when providing a patient-centered care service. The factors that influence the clinical decision-making process are grouped into clinical and non-clinical factors. Clinical factors that influence patient care decisions include:
- Physical examination findings
- Evidence-based medicine
- Diagnostic test results
- Patient’s medical history
- Clinical guidelines
Non-clinical factors include the patient’s age, socioeconomic status (SES), race, attitude and behavior. There are some factors that fall into a gray area; they are not clinical factors but are not non-clinical factors either, such as patient adherence. In this article, we will be focusing on the impact of socioeconomic factors on patient care decisions.
Socioeconomic factors are the conditions in which individuals are born, grow, work, live and age. They are the set of courses and systems that shape the conditions of an individual’s daily life. Studies have proven that socioeconomic status plays a major role in the quality of health that individuals can afford to receive and their health outcomes. Socioeconomic factors are also referred to as social determinants of health in the healthcare industry. Some socioeconomic factors include, Income, Education, Housing and Occupation.
Healthcare professionals are educated on how to navigate these factors and ensure the best quality care for their patients. An online accelerated BSN program, such as the one offered by University of Indianapolis, allows students to learn the holistic approaches to healthcare, with a flexible online structure to fit their schedule. This program includes a clinical placement where students gain hands-on experience in nursing and gather insight into the impacts of socioeconomic factors on their patients.
Income is the amount of money an individual receives on a daily, monthly or annual basis. Income can come from investments, jobs, retirement plans and government aid programs. The level of income an individual has affects their ability to afford proper healthcare and insurance. Individuals receiving high income are able to access better healthcare services, top specialist consultations and mental and physical illness preventive care.
High-income levels also support healthy lifestyle choices, such as better nutrition and access to top fitness facilities. Individuals with lower income levels often have limited access to healthcare and healthy lifestyle choices. Due to low levels of income, individuals delay seeking medical care as they often lack the funds to pay for such services. Studies have linked the rates of mortality in several countries to the distribution of income.
The link between income and health is more pronounced at lower income levels, but this does not mean that income health effects do not persist above the poverty level. It is clear that health effects at the upper part of income distribution in a society reflect a relative status. Meanwhile, in the lower part, income effects are linked to deprivation. Individuals with high-income levels tend to be healthier as they can afford specialized care that can effectively manage or totally cure certain illnesses.
Individuals with a high level of education are more likely to live longer with improved health. Individuals who have received secondary education at the best schools have higher literacy compared to people who have little to no formal education. Health literacy is the degree to which individuals can find, read, comprehend and use health-related services.
Patients with primary or lower education levels often find it difficult to understand medical terms and treatment options, so they tend not to comply with treatments. The higher the level of literacy, the higher the chances that an individual will seek appropriate treatment or government health aid services and live a longer life.
Aside from health impact, a high level of education is linked to acquiring great skills, better employment options and high incomes. Additionally, education is a major factor that improves an individual’s productivity and economic potential. It gives people the knowledge, abilities and competencies necessary to succeed in the job market. People with higher levels of education are more likely to obtain higher-paying employment and are more likely to be able to afford the best healthcare services.
Housing is a basic human need that provides us with a place to call home. It provides us with other fundamental needs such as safety, privacy and security. The cost of housing has a major impact on individuals’ financial, physical and emotional wellbeing. When housing costs take up a large portion of an individual’s income, they are left with little or no funds for other major needs such as healthcare.
Individuals and families with low income are often forced to live in poor homes with unstable structures or neighborhoods with health risks and high crime rates. This is because these homes and neighborhoods tend to have lower housing costs. Aside from the health issues caused by living in neighborhoods with higher crime rates and health risks, where you live determines the quality of healthcare service you can receive. Individuals living in the best neighborhoods and urban cities are able to access advanced healthcare facilities and services.
How socioeconomic factors affect patient care decisions
Socioeconomic factors are one of the major causes of health disparities and inequities. Health disparities are the systematic difference in the opportunities and access individuals, or minority groups have to better healthcare. Health disparities lead to avoidable and unfair negative health outcomes. The following are ways socioeconomic factors influence healthcare professionals’ patient care decisions.
Limited access to healthcare
Low socioeconomic status has been linked to reduced access to care, negative health outcomes and increased mortality rates. Some healthcare professionals tend to treat patients with low socioeconomic status with bias. Studies have also shown that healthcare professionals’ perception of patients with low SES affects their clinical decision-making process and healthcare delivery.
Doctors and nurses often perceive low SES patients as unintelligent or irrational. They believe low SES patients may not comply with medical treatment, advice or follow-up visitations. Due to these beliefs, healthcare professionals tend to change their care plans for patients with low SES. Some of the ways they may change their care plans include:
- Changing treatment methods
- Conducting fewer genetic tests that are covered only by insurance
- Prescribing low-grade medicine that is affordable but may not be as effective
Some doctors do not provide services to patients with low SES and publicly financed insurance because of low reimbursement rates. All these factors limit the access of individuals with low SES to healthcare, leading to the potential for poor health status and avoidable death.
Socioeconomic factors cause health disparities, which in turn affect patient care decisions. Health disparities are the differences between treatment care and health outcomes between population groups. Types of health disparities include:
- Race or ethnicity
Gender disparities, also known as gender inequities, refers to the informal societal roles and gender norms that affect how healthcare professionals make patient care decisions. Gender bias has a strong influence, which can negatively affect the wellbeing of males and females across all age groups.
For example, in the health sector, a common occurrence is male healthcare professionals downplaying female patients’ symptoms, description and pain levels as they perceive females as dramatic. It’s not just male healthcare professionals that treat female patients unfairly. Both male and female physicians and practitioners often dismiss female patients’ concerns and provide them with delayed and subpar care.
A study discovered that practitioners are more likely to treat female patients’ pains as a mental health condition instead of physical pain. Meanwhile, they treat men’s pain as a physical condition instead of a mental illness because men are perceived as brave. Gender disparities affect the methods and approaches doctors follow in delivering comprehensive patient care.
Race and ethnicity disparities
Racial and ethnic disparities (RED) are the unequal treatment that healthcare providers deliver to individuals of certain biological and cultural backgrounds or minority groups. Racial and ethnic disparities are persistent systematic differences that are the result of unconscious bias, negative stereotypes and institutional policies in the healthcare industry.
Several studies have proven that racial and ethnic minority groups receive poor treatment from healthcare professionals, increasing their morbidity and mortality rates. This bias is partially caused by the underrepresentation of minor populations in drug and treatment testing. Healthcare professionals do not have enough data on how specific treatments and education affect certain racial and ethnic groups, which causes challenges that affect their patient care decisions.
Addressing socioeconomic factors in healthcare
Despite the significant advancement in the healthcare sector, individuals with low socioeconomic status have higher disease and mortality rates. Addressing socioeconomic factors would help reduce the disparities that influence patient care and improve the overall wellbeing of the population. Several ways governments and organizations can address socioeconomic factors and their influence on the healthcare system include:
By implementing health in all policies and practices in healthcare and non-healthcare sectors, governments can boost health equity and positively influence patient care decisions. Health in all policies and practices are approaches that highlight and address how decisions in several sectors affect health. This addresses how improving socioeconomic factors by job creation and economic stability, transportation and other factors can affect health equity and vice versa.
Governments are already implementing health policies through organizations and workgroups. One of the major health policies that the US government has implemented includes the Affordable Care Act, also known as Obamacare, which is a comprehensive healthcare reform policy established at the federal level in March 2010. However, they have yet to implement guidelines ensuring healthcare facilities and professionals follow these policies.
Improving and leveraging healthcare data
The healthcare sector is one of the major industries that has a lot of fundamental data regarding the population. However, governments need to strengthen existing data that can provide valuable insights when treating several races and ethnic groups. Ways they can strengthen existing data include conducting fair and inclusive clinical trials and research.
When selecting participants for clinical research, clinical research coordinators (CRC) must ensure that they are not gender biased. By collecting and analyzing health data that covers effective and ineffective treatments for several minority groups, governments can positively influence patient care decisions.
Diverse health data provides more valuable insights and serves as a guideline healthcare professionals can follow to provide comprehensive care to individuals with lower socioeconomic factors. Ultimately, improving and leveraging health data reduces health disparities.
Provision of preventive education
Another strategy governments and organizations can employ in addressing the impact of socioeconomic factors on healthcare is providing adequate education. By providing formal education to individuals in local populations, healthcare organizations and governments can overcome the lack of awareness and knowledge about health.
Individuals with little to no education tend to be ignorant about health risks and consequences. People with higher education levels tend to understand and comply with healthcare professionals, making it easier for them to make accurate patient care decisions. However, to properly address the impact of socioeconomic factors on healthcare care, organizations need to provide education to both patients and healthcare professionals.
Governments can equip healthcare professionals with adequate knowledge and communication skills in training programs. Healthcare professionals with advanced knowledge and skills are more likely to deliver comprehensive and effective care to all individuals without bias.
Socioeconomic factors such as income, education and housing have negative and positive influences on doctor-patient care decisions. Healthcare professionals are more likely to deliver fewer preventive care services and prescribe less expensive medicines to patients with low SES.
Some doctors provide affordable treatment to patients with low SES to reduce the patient’s financial burdens while managing their health. Although it is well known that in the healthcare sector, affordable medicine and care are often not as effective as the costly ones. Expensive healthcare equals top-notch preventive care, medical interventions and better health outcomes.
To minimize the impact of socioeconomic factors on the professional patient care decision-making process, governments should implement policies that improve health equity and provide opportunities for individuals to receive the best healthcare services at lower costs. Advanced and effective healthcare shouldn’t be available to only individuals with middle or upper socioeconomic status.