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The European Journal of Public Health Advance Access published online on April 26, 2006
The European Journal of Public Health, doi:10.1093/eurpub/ckl040
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© The Author 2006. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received March 15, 2005
Accepted December 7, 2005

Article

Use of health care services by ethnic minorities in The Netherlands: do patterns differ?

Ellen Uiters 1, Walter L. J. M. Devillé 1 *, Marleen Foets 2, and Peter P. Groenewegen 1

1 Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
2 Institute of Health Policy and Management, Erasmus Medical Centre, Rotterdam, The Netherlands

* To whom correspondence should be addressed.
Walter L. J. M. Devillé, E-mail: w.deville{at}nivel.nl


  Abstract

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. Conclusion: 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.

Keywords: ethnicity; general practice; health service utilisation.
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