BMC Family Practice
Volume 15, Issue 1, 2014

Quality of primary care for resettled refugees in the Netherlands with chronic mental and physical health problems: A cross-sectional analysis of medical records and interview data (Article) (Open Access)

Van Melle M.A.* , Lamkaddem M. , Stuiver M.M. , Gerritsen A.A. , Devillé W.L. , Essink-Bot M.-L.
  • a Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
  • b Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
  • c Department of Clinical Epidemiology, Biostatistics and Bioinformatica, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
  • d Epi Result, Louis Trichardt, South Africa
  • e NIVEL (Netherlands Institute for Health Services Research), Utrecht, Netherlands, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, Netherlands, National Knowledge and Advisory Center on Migrants, Refugees and Health (Pharos), Utrecht, Netherlands
  • f Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands

Abstract

Background: A high prevalence of mental and physical ill health among refugees resettled in the Netherlands has been reported. With this study we aim to assess the quality of primary healthcare for resettled refugees in the Netherlands with chronic mental and non-communicable health problems, we examined: a) general practitioners' (GP) recognition of common mental disorders (CMD) (depression and anxiety, and post-traumatic stress disorder (PTSD) symptoms); b) patients' awareness of diabetes type II (DMII) and hypertension (HT); and c) GPs' adherence to guidelines for CMD, DMII and HT.Methods. From 172 refugees resettled in the Netherlands, interview data (2010-2011) and medical records (n = 106), were examined. Inclusion was based on medical record diagnoses for DMII and HT, and on questionnaire-based CMD measures (Hopkins Symptom Checklist for depression and anxiety; Harvard Trauma Questionnaire for PTSD). GP recognition of CMD was calculated as the number of CMD cases registered in the medical record compared with those found in interviews. Patient awareness of HT and DMII was scored as the percentage of subjects diagnosed by the GP who reported their condition during the interview. GPs' adherence to guidelines for CMD, DMII and HT was measured using established indicators.Results: We identified 37 resettled refugees with CMD of which 18 (49%) had been recognised by the GP. We identified 16 refugees with DMII and 14 with HT from the medical record; 24 (80%) were aware of their condition. Thirty-five out of these 53 (66%) resettled refugees with chronic mental and non-communicable disorders received guideline-adherent treatment.Conclusion: This study shows that awareness in resettled refugees of GP diagnosed DMII and HT is high, whereas GP recognition of CMD and overall guideline adherence are moderate. © 2014van Melle et al.; licensee BioMed Central Ltd.

Author Keywords

Primary care Chronic disease Quality of care Mental health Refugees

Index Keywords

anxiety Netherlands Afghanistan depression refugee Diabetes Mellitus, Type 2 human Refugees middle aged Practice Guidelines as Topic protocol compliance statistics and numerical data hypertension Guideline Adherence chronic disease ethnology Iran Cross-Sectional Studies cross-sectional study Humans psychology male female standards adult health care quality Somalia Quality of Health Care Stress Disorders, Post-Traumatic practice guideline primary health care
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84907992187&doi=10.1186%2f1471-2296-15-160&partnerID=40&md5=cba6246bb75d95f58c7a643874c8fb78
DOI: 10.1186/1471-2296-15-160
ISSN: 14712296
Cited by: 7
Original Language: English