Patient-physician agreement among vulnerable ethnic minority patients in Denmark

INTRODUCTION Medical doctors in Denmark are clinically challenged by ethnic minority patients, resulting in delayed or incorrect treatments. Apart from language barriers, little is known about the nature of the challenges presented by ethnic minority patients. The present study investigated the level of agreement between the patients' main problems, doctors' referral notes and patient-reported problems documented at a hospital-based migrant health outpatient clinic. METHODS A retrospective cross-sectional study was conducted on 150 patients referred to the Migrant Health Clinic (MHC), Odense University Hospital, Denmark. The study was based on a full "Problem list" that was co-produced with the patient. Cohen's kappa (kappa) and Chamberlain's proportionate positive agreement (p(ppa)) were calculated for the medical and socioeconomic problems described in the referrals and MHC notes, respectively. RESULTS Significant agreement between patient and referring doctor was found for only two health complaints: musculoskeletal pain (kappa = 0.43 and p(ppa) = 0.69) and Type 2 diabetes mellitus (kappa = 0.71 and p(ppa) = 0.59). CONCLUSIONS Doctors and patients rarely agree on the patients' health problems. Patient engagement such as co-production of care may potentially produce the time and resources needed to help doctors identify the patients' priorities and describe them in referrals.