Primary health care use among ethnic minorities in the Netherlands: a comparative study

This thesis aims to provide insight into differences in the actual use of health care services by ethnic minorities as compared to the indigenous Dutch population. Furthermore, the role of different determinants of health care utilisation is studied in order to establish to what degree ethnic differences in utilisation are explained by these determinants. In addition, this thesis also pays attention to the quality of care by comparing differences between ethnic groups concerning the perceived quality of general practitioner care. Our results confirmed the existence of ethnic differences in health care utilisation. These differences strongly depend on the type of health care service and vary considerably between the four minority groups. Ethnic differences in health care utilisation could only partly be attributed to differences in socio-demographic characteristics, acculturation and health status. Minority groups did not systematically differ in the perceiv! ed performance of their GP. In conclusion, our results show little evidence of an overall inequity in the receipt of health care by minority groups. However, our results suggest that there are systematic differences between ethnic groups which may indicate some problems of access to health services, reinforcing the need for continuing attention to ethnic patterns in health care utilisation. For instance, it is unclear why Moroccans in general tend to make less use of health care than the other three minority groups. Therefore, the importance of including ethnic background as an entity in health care research, with specific attention for the heterogeneity among minority groups, is underlined by our study.

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