Background. Little is known on the scope and nature of ethnic inequalities in suboptimal asthma care for children. This study aimed to assess (1) ethnic differences in suboptimal asthma care for children with an asthma exacerbation who consulted a physician, and (2) ethnic differences in the nature of suboptimal care. Methods. All children aged 6-16 years who during a period of six months consulted the paediatric department of the Academic Medical Centre-University of Amsterdam or one of the six regional primary care centres with an asthma exacerbation were included. Clinical guidelines were systematically converted to review criteria following the strategy as proposed by the Agency for Health Care Policy and Research. Based upon these review criteria and their experience experts of two multidisciplinary panels retrospectively assessed the quality of care and its (possible) failure to prevent the occurrence of asthma exacerbation. Results. Only a small number of children (n = 35) were included in the analysis as a result of which the ethnic differences in suboptimal care were not significant. However, the results do indicate immigrant children, in particular 'other non-Western' children (n = 11), more frequently to receive suboptimal care related to the asthma exacerbation when compared to ethnic Dutch children. Furthermore, we found the nature of suboptimal care to differ with under-prescribing in the 'other non-Western' group (n = 11), lack of information exchange between physicians in the Surinamese/Antillean group (n = 12) and lack of education, and counselling of patients and parents in the ethnic Dutch (n = 12) as the most relevant factor. Conclusion. Ethnic inequalities in the scope and nature of suboptimal asthma care for children in the Netherlands seem to exist. For the non-western immigrant groups the results indicate the importance of the prescription behaviour of the medical doctor, as well as the supervision by one health care provider. © 2008 Urbanus-van Laar et al; licensee BioMed Central Ltd.

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patient care Netherlands immigrant primary medical care health care policy health care personnel university hospital human statistics Practice Guidelines as Topic Guideline Adherence Medical Audit pediatrics clinical practice Adolescent Health Services ethnology patient counseling Humans ethnic difference Adolescent consultation male Emigrants and Immigrants asthma female medical informatics clinical article patient education Article migration disease exacerbation physician Academic Medical Centers child health care standard Child Health Services Health Services Accessibility retrospective study parent counseling Healthcare Disparities practice guideline pathophysiology primary health care health care delivery Child