More and more people in the Western world are diagnosed with chronic diseases, which are often treated with medications. This increases the risk of receiving potentially inappropriate medication (PIM). The risk varies between social groups, which may cause social inequality in medical treatment.

The healthcare sector may help maintain or reduce this inequality. General practice is crucial in promoting equal treatment, as general practitioners are located close to their patients, have a comprehensive overview of treatments and have the possibility to involve patients in decisions.

Significant social inequality

Based on register data and fieldwork, Amanda Paust has investigated associations between social position and potentially inappropriate medications in four studies forming part of her PhD project.

The results indicate that significant social inequality exists in medical care, and that it is related to differences in economic, cultural and social capital. Unwarranted variation in the quality of care is influenced by many factors, including the geographical location of the clinic, the organisation of the clinic, and the composition of its listed patient population.

Discordance between healthcare system and patients

Inequality in treatment can be explained by unalignment, or discordance, between general practice and patients, which implies a mismatch between the rhythms of the healthcare system and the patients' abilities and opportunities to understand, navigate, negotiate, and handle the temporal rhythms of treatment.

As part of the PhD project, the PREPAIR questionnaire was developed and tested. This questionnaire appears to facilitate preparation and involvement of the patient in the medication conversation in general practice, and such dialogue has already been shown to provide better care.

Defence on 2 May 2024

The PhD thesis and the four included scientific papers present the results of the three-year enrolment at the Graduate School of Health, Aarhus University. The project was carried out in a close collaboration between the Research Unit for General Practice in Aarhus and the Department of Public Health at Aarhus University.

The project was supported by unrestricted grants from the General Practice Research Foundation and Aarhus University.

Amanda Paust defends her PhD thesis ”Social inequality in medical treatment” on Thursday 2 May 2024 at 1.00 p.m. in the Eduard Biermann Auditorium (1252-204), Aarhus University, Bartholins Allé 3, 8000 Aarhus C.

The defence is public. Everyone is welcome. After the PhD defence, the research unit will host a small reception in room 118, building 1261, at the Department of Public Health, Aarhus University.

More information

PhD student Amanda Paust
Aarhus University, Department of Public Health &
Research Unit for General Practice
amasa@ph.au.dk, +45 4277 0628