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Differences in health care use between asylum seekers and refugees.
Devillé, W., Lamkaddem, M., Gerritsen, A.A.M., Ploeg, H.M. van der. Differences in health care use between asylum seekers and refugees. European Journal of Public Health: 2006, 16(Suppl. 1) 189. Abstract. 14 th Eupha conference "Politics, Policies and /or the Public's Health", Montreux, 16-18 November 2006.
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Asylum seekers have the same rights to health care than Dutch citizens. But in practice, while refugees are registered at a general practice, the health care for asylum seekers is regulated by the Community Health Services for Asylum seekers. The study examines differences in the respective health status and use of the health care system by asylum seekers and refugees in The Netherlands. Methods: A random sample of 232 asylum seekers and 178 refugees from Iran, Afghanistan, and Somalia were interviewed in their own language. Two hundred and twenty-eight complete medical records were collected from 12 months preceding the date of the interview. Contacts with the different health care providers, chronic health problems and reasons for encounter and laboratory tests were recorded. Results: Asylum seekers had 3.2 contacts per year with the general practitioner (GP), and 7.7 contacts per year with the community health nurse. Refugees had 6.1 contacts with the GP per year. In asylum seekers age and female gender were positively associated with frequency of use in a regression model, while the length of stay and good self-rated health were negatively associated. In refugees being female is also associated with a higher use of health care. The other determinants are different from those of asylum seekers. Being divorced and a low educational level are negatively associated with health care use intensity. Presenting Post-Traumatic Stress Disease (PTSD) symptoms, and reporting a higher number of health problems are positively associated. The opinion on health care shows a negative association with health care use. Conclusions: Among asylum seekers, a habituation mechanism reinforced by the active informative role of the nurse could be probable. In refugees PTSD symptoms still play an important role in the use of primary health care. Although previous research has shown that cultural differences and health care use are closely related, no significant differences between countries of origin were found in health care use intensity. (aut. ref.)
Asylum seekers have the same rights to health care than Dutch citizens. But in practice, while refugees are registered at a general practice, the health care for asylum seekers is regulated by the Community Health Services for Asylum seekers. The study examines differences in the respective health status and use of the health care system by asylum seekers and refugees in The Netherlands. Methods: A random sample of 232 asylum seekers and 178 refugees from Iran, Afghanistan, and Somalia were interviewed in their own language. Two hundred and twenty-eight complete medical records were collected from 12 months preceding the date of the interview. Contacts with the different health care providers, chronic health problems and reasons for encounter and laboratory tests were recorded. Results: Asylum seekers had 3.2 contacts per year with the general practitioner (GP), and 7.7 contacts per year with the community health nurse. Refugees had 6.1 contacts with the GP per year. In asylum seekers age and female gender were positively associated with frequency of use in a regression model, while the length of stay and good self-rated health were negatively associated. In refugees being female is also associated with a higher use of health care. The other determinants are different from those of asylum seekers. Being divorced and a low educational level are negatively associated with health care use intensity. Presenting Post-Traumatic Stress Disease (PTSD) symptoms, and reporting a higher number of health problems are positively associated. The opinion on health care shows a negative association with health care use. Conclusions: Among asylum seekers, a habituation mechanism reinforced by the active informative role of the nurse could be probable. In refugees PTSD symptoms still play an important role in the use of primary health care. Although previous research has shown that cultural differences and health care use are closely related, no significant differences between countries of origin were found in health care use intensity. (aut. ref.)