Use of health care services by ethnic minorities in The Netherlands: do patterns differ?
BACKGROUND
This article examines the nature of ethnic differences in health care utilisation by assessing patterns of use in addition to single service utilisation.


METHODS
Data were derived from the Second Dutch National Survey of General Practice. A nationally representative sample of 104 general practices participated in this survey. Data on health and health service utilisation were collected through face-to-face interviews. Based on a random sample per practice, a total of 12 699 Dutch-speaking people were interviewed, regardless of ethnic background. An additional study among a random sample of 1339 people from the four largest minority groups in The Netherlands was conducted. These four groups comprised people from Turkey, Surinam, Morocco, and The Netherlands Antilles. Multilevel analyses were performed to investigate ethnic differences in health care utilisation, adjusting for socio-economic status, health status, and level of urbanisation.


RESULTS
Differences in utilisation patterns were particularly marked for people with a Moroccan, Turkish, or Antillean background. Compared to the other groups, Surinamese were more likely to have had contact with any professional health care service. No evidence was found that the gate keeping role of general practitioners in The Netherlands functions less effectively among the ethnic minority groups as compared to the indigenous population.


CONCLUSIONS
The analysis of patterns of utilisation proved to supply useful information concerning the relationship between ethnicity and use of health care services in addition to figures concerning single service use only.
Uiters
Ellen
E
Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
Devillé
Walter L J M
WL
Foets
Marleen
M
Groenewegen
Peter P
PP
D000293:Adolescent; D000328:Adult; D003431:Cross-Cultural Comparison; D005006:Ethnicity / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D009018:Morocco / Q000208:ethnology; D009426:Netherlands; D013532:Suriname / Q000208:ethnology; D014421:Turkey / Q000208:ethnology; D014600:Utilization Review