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Equal rights, equal respect: an examination of differential inpatient experience in the NHS

In the National Health Service (NHS), patients’ experiences of care episodes in acute hospital trusts are measured through the NHS patient survey programme. These surveys use large samples of patients and include questions about ‘protected characteristics’ as set out in the Equalities Act 2010. Data were examined for one item in the 2011 Inpatient Survey measuring treatment with dignity and respect. They were analysed using multilevel regression models, incorporating ‘hospital trust’ as a random effect. Patient characteristics were entered as fixed main effects, and then as two-way interactions. The effect of allowing slope coefficients to vary for these characteristics was investigated. More negative reported experience of being treated with respect and dignity was associated with several demographic categories, including younger people, women, those affiliated with no or ‘another’ religion, gay/lesbian or bisexual individuals, those who did not disclose their religion or sexual orientation, specific ethnicities and certain chronic conditions. There were significant interactions between gender and other background variables, including age, sexual orientation, ethnicity, religious affiliation and certain chronic conditions. Random slope models suggested large hospital-trust-level variation in theexperience of certain groups. The results align with previous findings but are of particular interest in relation to religion and sexuality, for which data have hitherto been unavailable. However, the extent to which these reported differences might be due to differential expectations, reporting behaviours or discrimination is not clear. The results provide a starting point from which providers can analyse practices to identify where they might give rise to differences in treatment with dignity and respect.

Author(s): Katherine Ko¨rner, Steve Sizmur

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