68 Exploring Subconscious Bias: How Implicit Biases Can Affect Accessibility to Healthcare

Aim Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This article reviews healthcare professional's display of implicit bias towards patients in a tertiary centre. Method We retrospectively analysed a database of 285 patients who missed surgical outpatient appointments at a London tertiary hospital. Judges were asked to categorise all 285 patients into predefined ethnic categories: White British vs Black, Asian and Minority Ethnic vs White Non-British after reading the patient’s names. Results In the group where ethnicity was defined based on assessed origin of names, we report significant difference in discharge rates between White British vs Non-White British groups (34 vs 48%). There was also significant difference between White British vs Black, Asian and Minority Ethnic group (34% vs 57%). Discharge rates between males and females did not differ. Conclusions Clinicians are more likely to provide patients with another opportunity to attend an outpatient clinic after missing a booked appointment based on the patient having a perceived ethnicity of White British, whether deliberate or not. This study shows a bias of accessibility in healthcare dependent on ethnicity with greater flexibility given to White British patients.