Unfulfilled expectations of equal, respectful, or different treatment: Complaints of perceived ethnic, religious and gender discrimination in Swedish healthcare

Aim:
To analyse the occurrence and significance of complaints to the Equality Ombudsman (Diskrimineringsombudsmannen (DO)) of ethnic, religious and gender discrimination in Swedish healthcare in relation to discrimination as a social phenomenon.
Methods:
Through descriptive statistics and content analysis, we analysed complaints of discrimination on the grounds of ethnicity, religion and gender from 2012 to 2021 (N=431), and DO’s case supervision decisions (n=23).
Results:
DO has legally reviewed or initiated a supervisory process for only 23 (5%) of 431 cases and filed two lawsuits in the sample. Two-thirds of complainants were patients (n=284, 66%), one-fourth relatives (n=109, 25%), two healthcare professionals (1%) and 36 unspecified (8%). The most frequently reported healthcare sectors were primary healthcare centres (n=133, 31%), emergency care (n=50, 12%), women’s healthcare (n=47, 11%) and psychiatry/psychotherapy (n=40, 9%). Perceived discrimination concerned unfulfilled expectations of equal treatment (n=158, 37%), respectful treatment (n=151, 35%), different diagnosis or treatment (n=88, 20%), faster processing (n=15, 4%) and other (n=19, 4%).
Conclusions:
Complaints of ethnic, religious and gender discrimination in Swedish healthcare often report subtle discrimination or unmet expectations, and the reported discrimination is rarely legally confirmed. The results suggest that many reported cases are likely based on misunderstandings and communication problems. The unfulfilled expectations were often related to miscommunication, distrust or perceptions of being neglected. Healthcare providers should recognise these perceptions earlier and clarify any misunderstandings. The findings point to a need for further analysis of perceived discrimination in healthcare, and that more cases should be investigated.