Social disparities in healthcare encounters: A systematic review of qualitative studies in high-income countries

Background: 

Social disparities in healthcare access and utilisation are well-documented. However, the underlying mechanisms driving these disparities are not fully uncovered. This study presents a systematic review of qualitative research exploring organisational and relational factors that contribute to social disparities in healthcare encounters. 

Methods: 

The review was conducted in three scientific databases (PubMed, Embase and PsycInfo). Studies were independently screened by two researchers, and the quality was assessed using the Critical Appraisal Skills Programme assessment tool. A thematic analysis was used to identify patterns across included studies. 

Results: 

In total, 15 qualitative studies were included, from which 10 themes were identified, including: (1) complexity of the healthcare system, (2) resource constraints in the healthcare system, (3) deficiencies in healthcare professionals’ education, (4) patients’ perceptions of health and illness, (5) roles and expectations in patient decision-making and communication, (6) prejudices and labelling of patients with lower socioeconomic status, (7) equality and power balance in healthcare interactions, (8) patients’ financial and social living circumstances, (9) patients’ understanding of health information, and (10) trust and respect in healthcare interactions 

Conclusions: 

The study identified key mechanisms that contribute to social disparities in healthcare encounters between patients and the healthcare system. These findings may inform future health interventions and policy actions aimed at reducing social disparities in patient–healthcare interactions. However, further research within the Scandinavian context is warranted to validate and expand upon these results.