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Patient survey 'should be adjusted for ethnicity'

By Lilian Anekwe

Experts behind the GP Patient Survey have called for it to be re-designed to take into account the different expectations of ethnic minority patients.

Research published in the BMJ shows patients from ethnic minority backgrounds rate the care provided by their GP lower than white patients.

Black, Asian and Chinese patients rated all four aspects of GP performance significantly lower than white patients – which in some areas ‘appeared to reflect worse reported experiences by ethnic minority groups'.

In other cases researchers suggest the difference might have been caused by different expectations among certain ethnic minority groups, especially Asian patients.

The researchers, who include Professor Martin Roland, an advisor to Ipsos MORI on the design of the patient survey, concluded there are ‘important differences' in how white and ethnic minority patients assess their care that would mean that ‘adjusting the survey results for ethnicity may be justified'.

The team, from the universities of Cambridge and Manchester, analysed data from the general practice assessment questionnaire responses from nearly 190,000 patients collected between April 2005 and March 2006.

They measured the magnitude of the difference in mean scores between ethnic minority and white patients in each of four aspects of care: waiting times for a GP appointment with any or their preferred GP, time spent waiting in the surgery for appointment to begin, and continuity of care – defined as the proportion of consultations with their usual GP.

Professor Roland, professor of health services at the University of Cambridge, said the care of practices in deprived areas may be ‘unfairly represented' unless ethnicity was accounted for.

He concluded: ‘The argument for adjusting is that it would be unfair to compare practices providing the same standard of care without taking into account differences in the expectations of their populations.

‘Practices and primary care trusts in areas with a large ethnic minority population may think that their care is being unfairly represented if no allowance is made for differences in population expectations.'

Earlier this month Pulse revealed the Department of Health had been forced into weighting the results of the patient survey for age and gender, after Professor Roland's research suggested these factors were major contributors to non-responder bias.

Professor Roland told Pulse: ‘I think difference in ethnic mix of practices should at least be considered if the DH is thinking about adjusting for socio-demographic factors.'

The GP Patient Survey does not take account of respondent ethnicity

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