title: Healthcare consumption by ethnic minority people in their country of origin.
abstract: BACKGROUND
  Studies from the USA, New Zealand and Denmark suggest that many ethnic minority citizens obtain healthcare in their country of origin. Their reasons for doing so and the possible consequences remain unclear.
  
  
  METHODS
  We used data from the Healthy Life in an Urban Setting study to investigate the magnitude, types, self-reported reasons and determinants of past-year healthcare consumption in the country of origin by ethnic minority people living in the Netherlands. Individuals of African Surinamese (n = 2059), South-Asian Surinamese (n = 1915), Ghanaian (n = 1426), Moroccan (n = 1516) and Turkish (n = 2245) origin were included (recruited 2011-2013). We performed descriptive and stepwise logistic regression analyses.
  
  
  RESULTS
  Respondents of Turkish origin reported the highest healthcare utilization in the country of origin (21.3%) compared with Moroccan (9.8%), Ghanaian (6.6%), African Surinamese (4.8%) and South-Asian Surinamese (3.0%) respondents. The main services used were outpatient clinics, pharmacies and health centres. The chief reported motivations were healthcare for illness, dissatisfaction with care in the residence country and seeking second opinions. Physical health status, cultural distance to the Dutch healthcare system and Turkish origin were all independently associated with healthcare use in countries of origin.
  
  
  CONCLUSIONS
  Both health status and attitudes towards services in the countries of residence and origin are significantly associated with cross-border healthcare use. Further research is needed to clarify the reasons for the relatively high rates shown by Turkish respondents and to explore the consequences for health and for healthcare utilization in the country of residence.
authors.affiliation: 1 Department of Public Health, Academic Medical Centre at the University of Amsterdam, Amsterdam, Netherlands 2 Department of Cardiology, Academic Medical Centre at the University of Amsterdam, Amsterdam, Netherlands a.sekercan@amc.uva.nl.
authors.forename: Aydın
authors.initials: A
authors.lastname: Şekercan
authors.affiliation: 1 Department of Public Health, Academic Medical Centre at the University of Amsterdam, Amsterdam, Netherlands.
authors.forename: Majda
authors.initials: M
authors.lastname: Lamkaddem
authors.affiliation: 1 Department of Public Health, Academic Medical Centre at the University of Amsterdam, Amsterdam, Netherlands.
authors.forename: Marieke B
authors.initials: MB
authors.lastname: Snijder
authors.affiliation: 2 Department of Cardiology, Academic Medical Centre at the University of Amsterdam, Amsterdam, Netherlands.
authors.forename: Ron J G
authors.initials: RJ
authors.lastname: Peters
authors.affiliation: 1 Department of Public Health, Academic Medical Centre at the University of Amsterdam, Amsterdam, Netherlands.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Essink-Bot
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D001208:Asia / Q000208:ethnology; D003695:Delivery of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000208:ethnology* / Q000706:statistics & numerical data*; D005260:Female; D005869:Ghana / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D009018:Morocco / Q000208:ethnology; D009426:Netherlands; D014421:Turkey / Q000208:ethnology; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult