Discrimination for real? Rigorous examination of ethnic discrimination within Swedish primary health care

Discrimination in health care is prohibited by the Swedish Health and Medical Services Act.

Although research has examined treatment differences related to ethnicity in Swedish health care, there is a lack of studies rigorously examining ethnic discrimination; whereby patients are treated differently solely due to ethnicity and not some other factor. The aim of this 2-year project is to study whether patients with African and Middle Eastern (vs.

Swedish) backgrounds receive discriminatory treatment in one large Swedish primary care service: 1177-direct.

In doing so, we aim to identify and statistically control for other major pathways through which treatment differences may arise and which do not constitute direct discrimination, e.g., ethnic group differences in comorbidity and patient empowerment. The digital 1177-direct platform and its integrated chat allow for a natural experiment to be conducted.

It enables rigorous examination of discrimination through matching of patients regarding symptoms and medical factors and through text analysis of big data sets with supervised machine learning. Discriminatory patient-centeredness and treatment intensity will be studied.

This research will be conducted by researchers in psychology, economics, and health care science in collaboration with Swedish health care organizations.

By pinpointing the mechanisms underlying unequal care, the results should inform future interventions aimed at combatting inequalities in health care.