Ethnicity as a risk factor for consultations in primary health care and out-patient care
Sundquist, J.
Scandinavian Journal of Primary Health Care 11(3): 169-173
1993
ISSN/ISBN: 0281-3432 PMID: 8272647 DOI: 10.3109/02813439308994825Document Number: 335336
For 7 weeks in 1988 in a suburban area of Lund, Sweden, with foreign-born persons comprising 28% of its population, a physician recorded all visits by foreign-born persons and Swedes to the local primary health care center, the City Clinic (a private clinic for emergencies), another private clinic (home visits), and the emergency department and all out-patient clinics of the local hospital. The study examined the effect of ethnicity on consultation rates, admissions, and prescriptions in out-patient and primary health care clinics. Most visits were to the local primary health care center and to the hospital out-patient departments. Scandinavians were used as the standard when the researcher standardized for age and sex. Swedes were much less likely to visit the emergency department (relative risk [RR] = 0.69, 95% CI = 0.48-0.99). Foreign-born persons were more likely to visit the emergency department, but not significantly so (RR = 1.37, 95% CI = 0.95-1.99). Latin Americans had significantly more consultations at the local primary health care center than Scandinavians (RR = 1.6; 95% CI = 1.02-2.51). Persons born in Asia and Africa made significantly fewer visits to the center (RR = 0.44; 95% CI = 0.28-0.69). The numbers of Swedes and foreign-born persons granted sick leave were not different. Foreign-born patients received significantly fewer prescriptions than Swedes (0.84 vs. 0.99 prescriptions/ visit; odds ratio [OR] = 0.07). Foreign-born persons were admitted to the hospital significantly more often than Swedes (0.28 vs. 0.17 admissions/visit; OR = 1.87). Hospital admissions were significantly greater among non-Swedish Scandinavians (OR = 2.9) and Latin Americans (OR = 3.1). These findings reflect differences in health care visits between Swedes and foreign-born persons living in Sweden. Further research should examine whether morbidity or culture accounts for these differences so health providers can better meet the demands and needs of various ethnic groups.