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Access, treatment and outcomes of care: a study of ethnic minorities in Europe

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

Recent research has shown that ethnic minorities still have less access to medical care and are less satisfied with the treatment they receive and the outcomes of the health care process. This article assesses how migrants in Europe experience access, treatment and outcomes in the European health care systems.

Methods

Data were obtained from the QUALICOPC study (Quality and Costs of Primary Care in Europe). Regression analyses were used to estimate the access, treatment and outcomes of care for ethnic minorities.

Results

In several countries, migrants experience that the opening hours of their GP practice were too limited and indicate that the practice was too far away from their work or home (lower access). They are more likely to report negative patient–doctor communication and less continuity of care than native patients (worse treatment). In addition, they are less satisfied with the care they received and are more likely to postpone care (worse outcomes).

Conclusions

In general, migrants are still disadvantaged during the health care process. However, our results also indicate that satisfaction with the health care process improves for second-generation migrants in comparison with first-generation migrants.

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References

  • Berry JW (1997) Immigration, acculturation, and adaptation. Appl Psychol Int Rev 46:5–34. doi:10.1111/j.1464-0597.1997.tb01087.x

    Google Scholar 

  • Brzoska P, Ellert U, Kimil A, Razum O, Sass AC, Salman R, Zeeb H (2015) Reviewing the topic of migration and health as a new national health target for Germany. Int J Public Health 60:13–20. doi:10.1007/s00038-014-0617-z

    Article  PubMed  Google Scholar 

  • Buja A et al (2014) Characteristics, processes, management and outcome of accesses to accident and emergency departments by citizenship. Int J Public Health 59:167–174. doi:10.1007/s00038-013-0483-0

    Article  PubMed  Google Scholar 

  • Campbell JL, Ramsay J, Green J (2001) Age, gender, socioeconomic, and ethnic differences in patients’ assessments of primary health care. Qual Health Care 10:90–95. doi:10.1136/Qhc.10.2.90

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cleary PD, Mcneil BJ (1988) Patient satisfaction as an indicator of quality care inquiry. J Health Car 25:25–36

    CAS  Google Scholar 

  • Fontanella CA, Guada J, Phillips G, Ranbom L, Fortney JC (2014) Individual and contextual-level factors associated with continuity of care for adults with schizophrenia. Adm Policy Ment Health 41:572–587. doi:10.1007/s10488-013-0500-x

    Article  PubMed  PubMed Central  Google Scholar 

  • Haviland MG, Morales LS, Dial TH, Pincus HA (2005) Race/ethnicity, socioeconomic status, and satisfaction with health care. Am J Med Qual 20:195–203. doi:10.1177/1062860605275754

    Article  PubMed  PubMed Central  Google Scholar 

  • Kontopantelis E, Roland M, Reeves D (2010) Patient experience of access to primary care: identification of predictors in a national patient survey. BMC Fam Pract 11:Artn 61. doi:10.1186/1471-2296-11-61

  • Kringos DS, Boerma WGW, Hutchinson A, van der Zee J, Groenewegen PP (2010) The breadth of primary care: a systematic literature review of its core dimensions. BMC Health Serv Res 10:Artn 65. doi:10.1186/1472-6963-10-65

  • Love MM, Mainous AG, Talbert JC, Hager GL (2000) Continuity of care and the physician-patient relationship—the importance of continuity for adult patients with asthma. J Fam Pract 49:998–1004

    CAS  PubMed  Google Scholar 

  • Mainous AG, Diaz VA, Koopman RJ, Everett CJ (2007) Quality of care for hispanic adults with diabetes. Fam Med 39:351–356

    PubMed  Google Scholar 

  • Malmusi D, Drbohlav D, Dzurova D, Palencia L, Borrell C (2014) Inequalities in healthcare access by type of visa in a context of restrictive health insurance policy: the case of Ukrainians in Czechia. Int J Public Health 59:715–719. doi:10.1007/s00038-014-0592-4

    Article  PubMed  Google Scholar 

  • Marmot MG, Kogevinas M, Elston MA (1991) Socioeconomic status and disease WHO regional publications. Eur Ser 37:113–146

    CAS  Google Scholar 

  • Matschke C, Sassenberg K (2010) The supporting and impeding effects of group-related approach and avoidance strategies on newcomers’ psychological adaptation. Int J Intercult Rel 34:465–474. doi:10.1016/j.ijintrel.2010.04.008

    Article  Google Scholar 

  • Mead N, Roland M (2009) Understanding why some ethnic minority patients evaluate medical care more negatively than white patients: a cross sectional analysis of a routine patient survey in English general practices. Br Med J 339:Artn B3450. doi:10.1136/Bmj.B3450

  • Moy E, Freeman W (2014) Federal investments to eliminate racial/ethnic health-care disparities. Public Health Rep 129:62–70

    PubMed  PubMed Central  Google Scholar 

  • Nelson AR, Smedley BD, Stith AY (eds) (2002) Unequal treatment: confronting racial and ethnic disparities in health care. National Academies Press, Washington, DC

  • Oliver A, Mossialos E (2004) Equity of access to health care: outlining the foundations for action. J Epidemiol Commun Health 58:655–658. doi:10.1136/jech.2003.017731

    Article  Google Scholar 

  • Raymer J (2009) International migration in Europe: new trends and new methods of analysis. Popul Space Place 15:540–541. doi:10.1002/Psp.572

    Article  Google Scholar 

  • Razum O, Spallek J (2014) Addressing health-related interventions to immigrants: migrant-specific or diversity-sensitive? Int J Public Health 59:893–895. doi:10.1007/s00038-014-0584-4

    Article  PubMed  Google Scholar 

  • Rumbaut RG (2006) On the past and future of American immigration and ethnic history: a sociologist’s reflections on a silver jubilee. J Am Ethnic Hist 25:160–167

    Google Scholar 

  • Schafer WL et al (2011) QUALICOPC, a multi-country study evaluating quality, costs and equity in primary care. BMC Fam Pract 12:115. doi:10.1186/1471-2296-12-115

    Article  PubMed  PubMed Central  Google Scholar 

  • Schafer WL et al (2013) Measures of quality, costs and equity in primary health care instruments developed to analyse and compare primary care in 35 countries. Qual Prim Care 21:67–79

    PubMed  Google Scholar 

  • Stalker P (2002) Migration trends and migration policy in Europe. Int Migr 40:151–179. doi:10.1111/1468-2435.00215

    Article  Google Scholar 

  • Starfield B (2001) Improving equity in health: a research agenda. Int J Health Serv 31:545–566

    Article  CAS  PubMed  Google Scholar 

  • Stein BD, Kogan JN, Sorbero MJ, Thompson W, Hutchinson SL (2007) Predictors of timely follow-up care among medicaid-enrolled adults after psychiatric hospitalization. Psychiatr Serv 58:1563–1569. doi:10.1176/appi.ps.58.12.1563

    Article  PubMed  Google Scholar 

  • Szczepura A (2005) Access to health care for ethnic minority populations. Postgrad Med J 81:141–147. doi:10.1136/pgmj.2004.026237

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Weech-Maldonado R, Morales LS, Elliott M, Spritzer K, Marshall G, Hays RD (2003) Race/ethnicity, language, and patients’ assessments of care in Medicaid managed care. Health Serv Res 38:789–808. doi:10.1111/1475-6773.00147

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This article uses data collected within the QUALICOPC (Quality and Costs of Primary Care in Europe) project, which was co-funded by the European Commission under the Seventh Framework Programme (FP7/2007–2013) under Grant Agreement 242141. The authors thank their partners in the QUALICOPC project for their role throughout the study and their coordination of the data collection: University of Ljubljana, Hochschule Fulda, Sant’ Anna school of advanced studies, NIVEL (Dutch research institute of health care) and RIVM (National Institute for Public Health and the environment). Furthermore, we would like to thank the national coordinators for their cooperation and support during the fieldwork and data collection. At last our gratitude goes to the QUALICOPC study participants for their time and contribution to this study.

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Correspondence to Lise G. M. Hanssens.

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Compliance with Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments of comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Lise G. M. Hanssens declares that she has no conflict of interest. Jens Detollenaere declares that he has no conflict of interest. Wim Hardyns declares that he has no conflict of interest. Sara J. T. Willems declares that she has no conflict of interest.

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Hanssens, L.G.M., Detollenaere, J., Hardyns, W. et al. Access, treatment and outcomes of care: a study of ethnic minorities in Europe. Int J Public Health 61, 443–454 (2016). https://doi.org/10.1007/s00038-016-0810-3

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  • DOI: https://doi.org/10.1007/s00038-016-0810-3

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