Migrants\u2019 motives and expectations for contacting out-of-hours primary care: a survey study

Ellen Keizer,Michel Wensing,Peter Bakker,Femke Atsma,Paul Giesen,Marleen Smits,Maria Van Den Muijsenbergh

doi:10.1186/s12875-017-0664-7

Ellen Keizer, Michel Wensing + Show 5 more

Open Access

https://doi.org/10.1186/s12875-017-0664-7

Copy DOI

Abstract

BackgroundMigrants are more likely to use out-of-hours primary care, especially for nonurgent problems. Their motives and expectations for help-seeking are as yet unknown. The objective of this study is to examine the motives and expectations of migrants for contacting out-of-hours primary care.MethodsWe used data from a survey study of 11,483 patients who contacted a General Practitioner (GP) cooperative in the Netherlands between 2009 and 2014 (response rate 45.6%). Logistic regression analysis was used to test differences in motives and expectations between non-western and western migrants and native Dutch patients.ResultsThe main motives for contacting a GP cooperative for non-western and western migrants were an urgent need for contact with a GP (54.9%–52.4%), worry (49.3%–43.0%), and a need for medical information (21.3%–26.2%). These were also the most important motives for native Dutch patients. Compared to native Dutch patients, non-western migrants more often perceived an urgent need for a GP (OR 1.65; 99% CI 1.27–2.16), less often needed information (OR 0.59; 99% CI 0.43–0.81), and more often experienced problems contacting their own GP during office hours (OR 1.71; 99% CI 1.21–2.43). Western migrants also reported experiencing problems more often in contacting their own GP (OR 1.38; 99% CI 1.04–1.84).As well as for natives, most non-western and western migrants expected to see a doctor (46.2%–46.6%) or get advice (39.6%–41.5%). Non-western migrants expected more often to get physical examination (OR 1.53; 99% CI 1.14–2.04), and prescription (OR 1.37; 99% CI 1.00–1.88). We found no differences in expectations between western migrants and native Dutch patients.ConclusionThe main motives and expectations of migrants are similar to native Dutch patients, yet non-western migrants more often wanted action from the GP, e.g. examination or prescription, and less often passive forms of assistance such as giving information. At the same time they experience problems accessing their own GP. We recommend stimulation of self-care, education about the purpose of a GP cooperative, and examination and improvement of accessibility of daytime primary care.

Highlights

Migrants are more likely to use out-of-hours primary care, especially for nonurgent problems
Multiple imputation After multiple imputation of our data, we compared the descriptive statistics of the patient characteristics, motives and expectations of the original data with the pooled data
As the results were almost similar, we decided to present the results of the pooled data

Summary

Introduction

Migrants are more likely to use out-of-hours primary care, especially for nonurgent problems. Their motives and expectations for help-seeking are as yet unknown. The objective of this study is to examine the motives and expectations of migrants for contacting out-of-hours primary care. In 2015, 3.7 million inhabitants were migrants or children of migrants, which constituted 22% of the Dutch population [2]. Of these migrants, 56% have a non-western background and 44% a western background. General practices with a larger number of migrants in their patient population were found to have higher out-of-hours primary care use [11]

Objectives

Methods

Results

Discussion

Conclusion