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Quality of GP care, perceptions of ethnic minorities in The Netherlands.

Uiters, E.H., Sixma, H.J., Devillé, W., Groenewegen, P.P., Foets, M. Quality of GP care, perceptions of ethnic minorities in The Netherlands. European Journal of Public Health: 2005, 15(Suppl. 1) 135. Abstract. 13th Annual EUPHA Meeting "Promoting the public's health: reorienting health policies, linking health promotion and health care", Graz, 10-12 November 2005.
Background: Aim of our study is to gain insight into similarities and differences in patients’ evaluation of the quality of GP care between ethnic groups, and into factors explaining these differences. Subsequently, possible aspects for quality improvement will be derived.Methods: Health interview surveys in NIVEL’s Dutch National Survey of General Practice-2 (2001). A total of 12 699 indigenous and 1339 migrant clients from Turkey, Morocco, Surinam, and The Netherlands Antilles were interviewed. Independent variable: ethnic background. Control variables: socio-demographic variables and health status. Outcome variables: quality of GP care, measured by the QUOTE (quality of health care through the patient’s eyes). Quality of care will be studied in terms of relative importance and performance. Performance refers to the actual experience with GP care, whereas importance relates to the fact that patients perceive some features of GP care as more significant than others. Considering possible clustering on GP level, multilevel analyses were performed. Results: Preliminary results show that efforts to improve the quality of GP care should especially focus on involving an interpreter and providing leaflets in their own language. Intra-class
correlation coefficients (ICC) indicated that ethnic minority group patients from the same GP practices resemble each other more in what they find important in GP care than the indigenous population (ICC’s ranging from 0.04 to 0.36). With respect to their actual experience with GP care, clustering within GP practices was strongest among Moroccans and Antilleans (ICC’s ranging from 0.04 to 0.18). Conclusions: Ethnic minorities showed many similarities with the indigenous population in the evaluation of the quality of GP care. Most important entrance for quality improvement among the minority groups is related to language problems. The influence of the GP practice on the evaluation of the quality of care is stronger among ethnic minorities than among the indigenous population.(aut.ref.)
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