Race and age discrimination in the treatment of cardiac diseases in Indonesia

Karina Wibowo, Jacobs University Bremen

Background Race and age discrimination in medical treatment were carried out mainly in developed countries. Therefore this study investigates in the effect of race on physicians’ recommendation in cardiac categorization in Indonesia, standing for a developing country. Methods Video recorded interviews were shown to physicians on a computer, displaying patients describing symptoms. Based on these videos a survey was given to the physicians, who had to categorize the cardiac disease, give recommendations concerning the treatment and estimate the patient’s character. Results The ethnicity and age of the patient, the ethnicity of the doctor and the interaction between the ethnicity of the patient and the doctor indeed have an effect on the physicians’ recommendation (p<0.5). Physicians estimated Chinese more likely not showing up for follow up treatments (p<0.01), but at the same time they evaluated the character of the Chinese more positive than of the Indonesian (p<0.05). Old patients are estimated more satisfied (p<0.05) and the probability of coronary artery disease were higher (p<0.05) for them. Furthermore the cardiac categorization for young patients than older patients (p<0.05) and young Indonesian patient (p<0.01) were assessed more negative, which means, that they were more likely to be categorized under definitely not angina, even when the patient had angina pectoris. Discussion Based on the results race and age indeed have an effect on the physicians’ recommendation. Indonesian and young doctors were more likely to refer Chinese patients not for cardiac categorization, even when the description of the patient was clear that the patient had angina pectoris. Therefore Chinese were indeed discriminated by them. Furthermore, young patients and surprisingly young Indonesian patients (but not young Chinese patients) were discriminated. Still, the findings are most striking for Chinese patients in general and young patients, since the character and behavior of them were also estimated more negatively.