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Am J Public Health. 2010 Apr 1;100 Suppl 1:S113-7. doi: 10.2105/AJPH.2009.167064. Epub 2010 Feb 10.

Explaining ethnic disparities in patient safety: a qualitative analysis.

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  • 1Department of Social Medicine, Academic Medical Centre/University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.



We explored characteristics of in-hospital care and treatment of immigrant patients to better understand the processes underlying ethnic disparities in patient safety.


We conducted semistructured interviews with care providers regarding patient safety events involving immigrant patients in in-hospital medical care and treatment, for a total of 30 cases. Interviews were transcribed and qualitatively analyzed with a framework method.


Three key patterns were identified from the analysis. Patient safety events occur because of (1) inappropriate responses by health care providers to objective characteristics of immigrant patients, such as low Dutch language proficiency, lack of health insurance, or genetic conditions; (2) misunderstandings between patients and care providers because of differences in illness perceptions and expectations about care and treatment; and (3) inappropriate care because of providers' prejudices against or stereotypical ideas regarding immigrant patients.


Our findings suggest that organizational and health professional practices contribute to the higher risk of patient safety events. Descriptive epidemiological research is needed to explore the impact of the 3 patterns on patient safety.

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