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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Educational inequalities in patient-centred care: patients' preferences and experiences

BMC Health Services Research > Ausgabe 1/2012
Jany Rademakers, Diana Delnoij, Jessica Nijman, Dolf de Boer
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-261) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare they have no competing interests.

Authors' contributions

JR conceived and designed the study and wrote the first draft of the manuscript, DdB contributed to the conception and design of the study, performed the data-analysis and contributed to the first draft. JN prepared the dataset and assisted DdB in the data-analysis. DdB and DD commented on and contributed to draft versions of the manuscript. All authors read and approved the final manuscript.



Educational attainment is strongly related to specific health outcomes. The pathway in which individual patient-provider interactions contribute to (re)producing these inequalities has yet to be studied. In this article, the focus is on differences between less and more highly educated patients in their preferences for and experiences with patient-centred care., e.g. shared decision making, receiving understandable explanations and being able to ask questions.


Data are derived from several Consumer Quality-index (CQ-index) studies. The CQ-index is a family of standardized instruments which are used in the Netherlands to measure quality of care from the patient’s perspective.


The educational level of patients is directly related to the degree of importance patients attribute to specific aspects of patient-centred care. It has a minor influence on the experienced level of shared decision making, but not on experiences regarding other aspects of patient-centred care.


All patients regard patient-centred care as important and report positive experiences. However, there is a discrepancy between patient preferences for patient-centred care on one hand and the care received on the other. Less educated patients might receive ‘too much’, and more highly educated patients ‘too little’ in the domains of communication, information and shared decision making.
Authors’ original file for figure 1
Authors’ original file for figure 2
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