Ethnic differences in management of anxiety and depression in general practice in urban areas in the Netherlands in 2007.

Fassaert, T., Nielen, M.M.J., Verheij, R.A., Verhoeff, A., Dekker, J., Beekman, A.T.F., Wit, M.A.S. de. Ethnic differences in management of anxiety and depression in general practice in urban areas in the Netherlands in 2007. European Journal of Public Health: 2010, 20(suppl. 1), p. 154. Abstract. 3rd European Public Health Conference 'Integrated Public Health', 10 - 13 November 2010, Amsterdam.
Background: A substantial part of the population in western countries has a non-western ethnic background, and there is widespread concern that access to and quality of care (QoC) for mental health problems for ethnic minority groups are lower in comparison to the host populations. Health services in The Netherlands are generally well accessible as a consequence of mandatory basic health insurances for all citizens, which provide an interesting setting for the study of ethnic disparities in care for anxiety and depression (CMD) in general practice. Methods: Data from The Netherlands Information Network of General Practice in 2007 (89 practices, 340 000 patients) and population registries were collected. Prevalence of CMD in general practice, based on the International Classification of Primary Care was compared with the prevalence in the general population (indication for CMD detection). QoC was indicated by at least five general practice consultations, prescription of psychotropics for at most six weeks or at least 5 months, and/or referral to a mental health care specialist. Data were analysed using multilevel multiple regression techniques. Results: CMD were prevalent among 6413 patients (4.43%), and more often registered among Turkish patients than among ethnic Dutch. Detection of CMD by GPs was less adequate among Turkish patients. Of patients diagnosed with CMD, 42.9% received guideline-concordant treatments. Guideline adherence was lower among Surinamese/Antillean patients (odds ratio = 0.70, 95% confidence interval = 0.51–0.96). No disparities regarding QoC were observed for Turkish and Moroccan patients compared with ethnic Dutch. Conclusions: The quality of treatment among subjects diagnosed with CMD in Dutch general practice was comparable between ethnic groups. However, there were some unfavourable results among Turkish and Surinamese/Antillean patients, which underline the importance of continuing efforts to make GPs aware of the higher prevalence of CMD in some ethnic minority groups, and to further improve the accessibility to good quality care in general practice. (aut. ref.)