Differences in health care utilisation between elderly from ethnic minorities and ethnic Dutch elderly

Abstract

IntroductionIn the Netherlands, as in other Western countries, ethnic minority elderly are more often in poorer health than the indigenous population. The expectation is that this health disadvantage results in more frequent use of health care services.MethodsWe studied registered data on the proportion of health care receivers, frequency of use, and health care costs collected by a major Dutch health insurance company in 2010. Data from 10,316 Turkish, 14,490 Moroccan, 8,619 Surinamese, and 1,064 Moluccan adults aged 55 years and older were compared with data from a sample of 33,725 ethnic Dutch older adults.ResultsUnadjusted and adjusted (for age and gender) analyses showed the following. Moluccans had lower usage levels for all types of health care services. Use of primary health care facilities was higher for Turks, Moroccans, and Surinamese compared with the ethnic Dutch, with the exception that physical therapy was less frequently used among the Turks and Moroccans. Use of hospital care was lower, except for the Surinamese, who had a similar level of usage to that of the ethnic Dutch.ConclusionsThe health disadvantage previously observed within most ethnic minority elderly populations does not result in an overall more frequent use of health care services. Further research is needed for the interpretation of the ethnic variations in health care use as potentially inequitable, by taking medical need, patient treatment preferences, and treatment adherence into account.

A systematic review of the use of health services by immigrants and native populations

“…Table 2 shows the information extracted from the included publications. Of the 36 studies included, 8 were duplicated in both the manual and electronic search [ 13 – 20 ], 12 were included after the manual search [ 21 – 32 ] and 16 through the electronic search [ 33 – 48 ]. Among them, at least 9 partly describe the same dataset [ 13 – 16 , 19 , 20 , 25 , 47 , 48 ].…”

“…Distribution of studies regarding publication year was as follows: 8 studies published in 2013 [ 17 , 22 – 24 , 27 , 28 , 41 , 42 ], 15 in 2014 [ 14 – 16 , 19 , 21 , 30 , 32 , 33 , 35 , 36 , 38 , 40 , 43 , 44 , 47 ], 10 in 2015 [ 13 , 18 , 25 , 26 , 29 , 31 , 34 , 45 , 46 , 48 ] and 3 in 2016 [ 20 , 37 , 39 ]. The majority of the publications analysed data from European countries (28; 78%), both North and Central (12) (Norway [ 13 – 15 , 19 , 20 ], Denmark [ 45 ], Sweden [ 35 ], the Netherlands [ 17 , 32 , 34 , 40 ] and Austria [ 41 ]) and South Europe (15) (France [ 22 , 36 ], Italy [ 18 , 24 , 29 , 37 , 43 ], Spain [ 23 , 27 , 28 , 31 , 38 , 39 , 46 ] and Portugal [ 33 ]) and 1 from the UK [ 26 ]. Seven papers (19%) explored this issue in North America (2 from USA [ 30 , 34 ] and 5 from Canada [ ...…”

“…Geographical coverage of the studies has some variation: 21 performed at the national level [ 13 – 15 , 17 , 19 – 22 , 28 , 30 , 32 , 34 – 36 , 38 , 40 , 41 , 45 – 48 ], 10 at a regional level [ 16 , 18 , 23 , 25 – 27 , 29 , 31 , 37 , 44 ], 3 at a local level [ 28 , 33 , 42 ] and 1 multi-country study [ 39 ] with data from a regional level of 1 country and the national level of the other. There were only 4 longitudinal studies (2 prospective [ 18 , 42 ] and 2 retrospective [ 27 , 43 ]) and 1 case-control study [ 35 ].…”

“…Multivariable regression (Poisson or logistic) was the most frequent analysis. Only 9 studies conducted univariate analysis [ 29 , 32 , 33 , 35 , 38 , 43 , 48 ].…”

Cardiovascular Health and Related Health Care Use of Moluccan-Dutch Immigrants

“…We instead found for Moluccans to visit the GP less frequently, a finding that corresponds to a recent study of Verhagen et al, which found systematically lower health care usage among Moluccans compared to the native Dutch. [ 26 ] Regarding specialists consultations, cardiologist visits were only slightly less common among Moluccans, and neurologist consultations were equally common among Moluccans compared to the native Dutch. This pattern might be specific to the care for cardiovascular patients, where the importance of adhering to clinical guidelines might overrule potential inequalities in the use of health care.…”