Quality of care for anxiety and depression in different ethnic groups by family practitioners in urban areas in the Netherlands.
OBJECTIVE
There is widespread concern about access to good quality health care for ethnic minority groups. This study investigates differences between ethnic groups regarding prevalence of anxiety and depression, and adherence to treatment guidelines by family practitioners in urban areas in the Netherlands.


METHODS
Data from electronic medical records, collected for the Netherlands Information Network of General Practice. Diagnoses were based on the International Classification of Primary Care. Adherence to guidelines included at least five consultations, prescription of psychotropics for 6 weeks at most (indicative of cessation in case of nonresponse) or 5 months at least (suggesting continuation in case of response), and/or a referral to a mental health care specialist. Data were analyzed using multilevel logistic regression analyses.


RESULTS
A total of 6413 patients (4.4% of practice population) were diagnosed with anxiety and/or depression. Prevalence was highest in Turkish patients (5.2%). Of diagnosed patients, 42.9% received guideline-concordant treatment. Only Surinamese/Antillean patients were less likely than ethnic Dutch to receive treatments according to guidelines.


CONCLUSIONS
Prevalence of and quality of care for anxiety and depression were comparable between ethnic minority clients, but some differences suggest that efforts to educate primary care providers in management of anxiety/depression should be continued and tailored to specific ethnic groups.
Fassaert
Thijs
T
Department of Epidemiology, Documentation and Health Promotion, Municipal Health Service, 1000 CE Amsterdam, The Netherlands. tfassaert@ggd.amsterdam.nl
Nielen
Mark
M
Verheij
Robert
R
Verhoeff
Arnoud
A
Dekker
Jack
J
Beekman
Aartjan
A
de Wit
Matty
M
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000628:therapy*; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D005006:Ethnicity / Q000523:psychology; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000208:ethnology; D009426:Netherlands; D010821:Physicians, Family / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards; D013532:Suriname / Q000208:ethnology; D014421:Turkey / Q000208:ethnology; D014505:Urban Population