Health care utilisation by ethnic minorities in the Netherlands.

Background: An increasing number of migrants is living in Europe, but little is known about their access to health care services. Research indicates that the health care utilisation of migrants differs from the native population. However, most studies were undertaken in a local setting and included a relatively small numbers of migrants. Therefore, we decided to conduct a survey among the four largest groups of migrants in the Netherlands, in addition to a national representative health survey. Aim: To assess whether migrants differ in the use of health care services as compared to the Dutch population. Methods: 12.699 autochthonous and 1339 migrants from Turkey, Morocco, Surinam and the Netherlands Antilles were interviewed. Independent variable: ethnicity. Control variables: age, gender, education, perceived general health, chronic conditions, type of health insurance and level of urbanisation. Outcome variables: use of health care services (GP services; outpatient specialist; physiotherapist; hospital admission and homecare;) and drug use (prescribed and not prescribed). Multilevel analyses were applied. Results: Results show that migrants were more likely to have used GP services and outpatient specialist services than the Dutch population. GP services were most frequently used by Turks (OR= 1.45, 95% CI: 1.16-1.81), outpatient specialist services most frequently by Antilleans (OR=1.83, 95% CI: 1.36–2.45). Remarkable was that both services were least used by Moroccans. Utilisation of physiotherapist, homecare, drugs and hospital admission appeared to be lower among the migrants compared to the Dutch population. Conclusions: Congruently with former research, our results suggest that migrants differ from the Dutch population in the use of health care services. Except for Moroccans, no indications were found for limited access to basic services as the outpatient specialist and the general practitioner. The results only concern accessibility; quality of care was not studied. (aut.ref.