The Association Between the Perceived Unjust Treatment in Healthcare Settings and the Unmet Need for General Practitioner Services Among People With Foreign Background in Finland

Abstract

Background: Unjust experiences are relatively common among people with foreign background (PFB) in Finland. Despite universal access to public health care, previous studies have shown inequities in the unmet need for medical care between immigrants and the general population. This study examines the association between unjust treatment in healthcare settings and unmet need for general practitioner (GP) services among PFB. Method: The data for this study were drawn from Survey on work and well-being among people of foreign origin (UTH) (n = 4977, response rate 66%). The respondent characteristics were weighted and summarized, and multivariate logistic regression analyses were performed to assess the adjusted odds ratios (OR) of association between perceived unjust treatment and unmet need for GP services. The analyses were conducted in a four-step process where the first model tested the association between unjust treatment in health care settings and unmet need for GP services, second model adjusted this association by sociodemographic factors, third model was further adjusted by migration related factors, and the fourth model adjusted the previous models even further by health related factors.Results: The results of multivariate regression showed that PFB reporting unjust treatment were also significantly more likely to report an unmet need for GP services. The difference remained significant even after controlling for other tested factors (OR=8.68, 95% CI 6.09-12.36, p<.001). In addition to perceived unjust treatment, only younger age, lower self-rated health and existing long-term illness were significantly associated with unmet need for medical care in the final, fully adjusted model.Conclusions: Thus, perceived unjust treatment in health care settings is significantly associated with unmet need for general practitioner services. Ensuring cultural competence throughout the entire organizational structures creates an environment to promote equal treatment for all clients. The overall costs can be reduced effectively by giving the best possible treatment for all health care users.