Healthcare Utilisation of Moluccans in the Netherlands: Equal Care for Equal Need after 60 Years of Residence in the Host Country?

Background: In many countries, recent migrants have difficulties using healthcare to the same extent as host populations. It is uncertain whether these differences persist for long-settled migrants. This study examined healthcare utilisation of Moluccans in 2012, more than 60 years after they migrated from Indonesia to the Netherlands. Methods: A survey was held among 715 Moluccans and 3417 Dutch persons. Differences in healthcare utilisation were assessed using regression analyses adjusting for age, gender, indicators of health, religious affiliation, and education. Results: Moluccans had lower rates of healthcare use, including visits to the general practitioner (odds ratio (OR) = 0.67), outpatient medical specialist (OR = 0.50), dentist (OR = 0.65), and physiotherapist (OR = 0.56), as well as the use of paid housekeeping services (OR = 0.37). Among those who visited a healthcare service, no difference was found between Moluccans and Dutch in the frequency of visits, except for physiotherapist visits (rate ratio (RR) = 0.51). For the risk of hospitalisation, no difference was found; however, of those admitted to the hospital, the frequency of admission was lower among Moluccans than Dutch (RR = 0.74). Conclusions: Despite their long residence in the host country, equal utilisation of healthcare services has not been achieved for Moluccans in the Netherlands. Demand-based factors (e.g., family networks, health beliefs, and use of traditional medicine) may contribute to the persistence of such differences and require further investigation.

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Identifying and delineating the type 2 diabetes population in the Netherlands using an all-payer claims database: characteristics, healthcare utilisation and expenditures

BMJ Open ◽

10.1136/bmjopen-2021-049487 ◽

2021 ◽

Vol 11 (12) ◽

pp. e049487

Author(s):

Rose J Geurten ◽

Arianne M J Elissen ◽

Henk J G Bilo ◽

Jeroen N Struijs ◽

Chantal van Tilburg ◽

...

Keyword(s):

Type 2 Diabetes ◽

The Netherlands ◽

Health System ◽

Pharmaceutical Care ◽

Healthcare Utilisation ◽

Medical Specialist ◽

Specialist Care ◽

Policy And Practice ◽

Claims Database

ObjectivesWe aimed to identify and delineate the Dutch type 2 diabetes population and the distribution of healthcare utilisation and expenditures across the health system from 2016 to 2018 using an all-payer claims database.DesignRetrospective observational cohort study based on an all-payer claims database of the Dutch population.SettingThe Netherlands.ParticipantsThe whole Dutch type 2 diabetes population (n=900 522 in 2018), determined based on bundled payment codes for integrated diabetes care and medication use indicating type 2 diabetes.Outcome measuresAnnual prevalence of type 2 diabetes, comorbidities and characteristics of the type 2 diabetes population, as well as the distribution of healthcare utilisation and expenditures were analysed descriptively.ResultsIn 2018, 900 522 people (6.5% of adults) were identified as having type 2 diabetes. The most common comorbidity in the population was heart disease (12.1%). Additionally, 16.2% and 5.6% of patients received specialised care for microvascular and macrovascular diabetes-related complications, respectively. Most patients with type 2 diabetes received pharmaceutical care (99.1%), medical specialist care (97.0%) and general practitioner consultations (90.5%). In total, €8173 million, 9.4% of total healthcare expenditures, was reimbursed for the type 2 diabetes population. Medical specialist care accounted for the largest share of spending (38.1%), followed by district nursing (12.4%), and pharmaceutical care (11.5%).ConclusionsAll-payer claims databases can be used to delineate healthcare use: this insight can inform health policy and practice and, thereby, support better decisions to promote long-term sustainability of healthcare systems. The healthcare utilisation of the Dutch type 2 diabetes population is distributed across the health system and utilisation of medical specialist care is high. This is likely to be due to presence of concurrent morbidities and complications. Therefore, a shift from a disease-specific approach to a person-centred and integrated care approach could be beneficial in the treatment of type 2 diabetes.

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Acculturation of Syrian refugees in the Netherlands: Religion as social identity andboundary marker

Journal of Refugee Studies ◽

10.1093/jrs/feaa020 ◽

2020 ◽

Cited By ~ 1

Author(s):

AyŞe Şafak-AyvazoĞlu ◽

Filiz KünüroĞlu ◽

Fons Van de Vijver ◽

Kutlay YaĞmur

Keyword(s):

Social Identity ◽

The Netherlands ◽

Coping Strategies ◽

Host Country ◽

Religious Identity ◽

Cultural Distance ◽

Religious Affiliation ◽

Syrian Refugees ◽

Acculturation Process ◽

Depth Interviews

Abstract We studied the acculturation processes of Syrian refugees in the Netherlands, based on semi-structured in-depth interviews. The study aims to investigate how Syrian refugees perceive the cultural distance caused by the differences and boundaries between Syrian and Dutch culture; how they cope with the boundaries and prejudice that they perceive; and which acculturation orientations they prefer. The research builds mainly on the framework of Berry’s acculturation model. Religion emerges as a prominent issue in the acculturation process and is found to impact acculturation as it is perceived to be a cause of cultural distance, a salient social identity, a bright boundary and a source of prejudice in the host country. Our findings suggest that refugees’ religious identity strongly influences their coping strategies and preferred acculturation orientations. Refugees with low/no religious affiliation were more in favour of an assimilation orientation whereas refugees with strong religious identity preferred an integration orientation.

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Utilization Of Healthcare Services To General Patient At Inpatient Unit of Anutapura General Hospital, Palu City

Preventif : Jurnal Kesehatan Masyarakat ◽

10.22487/preventif.v10i1.118 ◽

2020 ◽

Vol 10 (1) ◽

pp. 35-44

Author(s):

Fausiah Fausiah

Keyword(s):

Health Services ◽

General Hospital ◽

Health Beliefs ◽

Secondary Data ◽

Healthcare Services ◽

Primary Data ◽

Utilization Of Health Services ◽

The People ◽

Quantitative Descriptive ◽

Utilization Of Healthcare

The number of inpatient visits in RSU Anutapura Palu, where in 2015 inpatient visits of 5,640, then in 2016 patient visits decreased to 5,451, in 2017 also decreased to 3,999 and in 2018 also decreased Drastic to 1,146 patient visits. This research aims to determine the utilization of health services in patients in general hospitalization in RSU Anutapura Palu. This type of research is quantitative descriptive. Research was conducted from May-June 2019. The population in the study is a visitor (number of hospitalizations) at the General Hospital (RSU) Anutapura Palu. In this case the people who use health services in the General Hospital (RSU) Anutapura Palu recorded as many as 1,146 visitors (patients) in the year 2018. Primary data collection is through questionnaires and secondary data through the study of patient record documents and other supporting documents. The utilization of health services in patients in general hospitalization in RSU Anutapura Palu is well from the aspects of health beliefs, abilities and needs. RSU Anutapura Palu is expected to be able to improve the promotion of health services so that people use the health services provided.

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Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-045343 ◽

2021 ◽

Vol 11 (3) ◽

pp. e045343

Author(s):

Ray Moynihan ◽

Sharon Sanders ◽

Zoe A Michaleff ◽

Anna Mae Scott ◽

Justin Clark ◽

...

Keyword(s):

Systematic Review ◽

Primary Outcome ◽

Unmet Need ◽

Healthcare Utilisation ◽

Healthcare Services ◽

Risk Of Bias ◽

Secondary Outcome ◽

Severe Illness ◽

Service Utilisation ◽

Registration Number

ObjectivesTo determine the extent and nature of changes in utilisation of healthcare services during COVID-19 pandemic.DesignSystematic review.EligibilityEligible studies compared utilisation of services during COVID-19 pandemic to at least one comparable period in prior years. Services included visits, admissions, diagnostics and therapeutics. Studies were excluded if from single centres or studied only patients with COVID-19.Data sourcesPubMed, Embase, Cochrane COVID-19 Study Register and preprints were searched, without language restrictions, until 10 August, using detailed searches with key concepts including COVID-19, health services and impact.Data analysisRisk of bias was assessed by adapting the Risk of Bias in Non-randomised Studies of Interventions tool, and a Cochrane Effective Practice and Organization of Care tool. Results were analysed using descriptive statistics, graphical figures and narrative synthesis.Outcome measuresPrimary outcome was change in service utilisation between prepandemic and pandemic periods. Secondary outcome was the change in proportions of users of healthcare services with milder or more severe illness (eg, triage scores).Results3097 unique references were identified, and 81 studies across 20 countries included, reporting on >11 million services prepandemic and 6.9 million during pandemic. For the primary outcome, there were 143 estimates of changes, with a median 37% reduction in services overall (IQR −51% to −20%), comprising median reductions for visits of 42% (−53% to −32%), admissions 28% (−40% to −17%), diagnostics 31% (−53% to −24%) and for therapeutics 30% (−57% to −19%). Among 35 studies reporting secondary outcomes, there were 60 estimates, with 27 (45%) reporting larger reductions in utilisation among people with a milder spectrum of illness, and 33 (55%) reporting no difference.ConclusionsHealthcare utilisation decreased by about a third during the pandemic, with considerable variation, and with greater reductions among people with less severe illness. While addressing unmet need remains a priority, studies of health impacts of reductions may help health systems reduce unnecessary care in the postpandemic recovery.PROSPERO registration numberCRD42020203729.

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A qualitative study on the experiences of southern European immigrant parents navigating the Norwegian healthcare system

International Journal for Equity in Health ◽

10.1186/s12939-021-01384-8 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Raquel Herrero-Arias ◽

Esperanza Diaz

Keyword(s):

Healthcare System ◽

Health Beliefs ◽

Diagnostic Tests ◽

Home Country ◽

Healthcare Services ◽

Diagnosis And Treatment ◽

Immigrant Parents ◽

Health Providers ◽

Treatment Practices ◽

Cultural Health Beliefs

Abstract Background Patients’ experiences with health providers and their diagnostic and treatment expectations are shaped by cultural health beliefs and previous experiences with healthcare services in home country. This study explores how Southern European immigrant parents navigate the Norwegian healthcare system, through its focus on how this group manage their expectations on diagnosis and treatment practices when these are unmet. Methods The study had a qualitative research design. Fourteen in-depth interviews and two focus group discussions with 20 Southern European immigrant parents were conducted in 2017 in three Norwegian municipalities. With the help of NVivo software, data were transcribed verbatim and coded. Following a thematic analysis approach to identify patterns in immigrants’ experiences with the Norwegian healthcare services, the codes were organized into two themes. Results The first theme includes immigrants’ expectations on diagnostic tests and medical treatment. Southern European immigrants expected more diagnostic tests and pharmacological treatment than what was deemed necessary by Norwegian health providers. Experiences with unmet expectations influenced how immigrants addressed their and their children’s healthcare needs. The second theme comprises immigrants’ experiences of seeking healthcare in Norway (attending medical consultations in the private sector, seeking immigrant healthcare providers, and navigating the healthcare through their Norwegian social networks). This category includes also the alternative solutions immigrants undertook when they were dissatisfied with the diagnosis and treatment practices they were offered in Norway (self-medication and seeking healthcare in home countries). Conclusions Cultural health beliefs and previous experiences with healthcare services from home country shaped immigrants’ expectations on diagnosis and treatment practices. This had great implications for their navigation through the healthcare system and interactions with health providers in the host country. The study suggests that successful inclusion of immigrants into the Norwegian healthcare system requires an acknowledgement of the cultural factors that influence access and use of healthcare services. Exploring immigrants’ perspectives and experiences offers important information to understand the challenges of cross-cultural healthcare and to improve communication and equitable access.

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Regional and hospital variation in commonly performed paediatric otolaryngology procedures in the Netherlands: a population-based study of healthcare utilisation between 2016 and 2019

BMJ Open ◽

10.1136/bmjopen-2020-046840 ◽

2021 ◽

Vol 11 (7) ◽

pp. e046840

Author(s):

Juliëtte J C M van Munster ◽

Joost J G Wammes ◽

Rolf H Bremmer ◽

Amir H Zamanipoor Najafabadi ◽

Raphael J Hemler ◽

...

Keyword(s):

The Netherlands ◽

Healthcare Utilisation ◽

Care Process ◽

Resource Utilisation ◽

Ventilation Tube ◽

Tube Insertion ◽

High Quality ◽

Cross Sectional ◽

Referral Rates ◽

Hospital Variation

ObjectiveIn the past few decades, there has been an increase in high-quality studies providing evidence on the effectiveness of commonly performed procedures in paediatric otolaryngology. We believe that now is the time to re-evaluate the care process. We aimed to analyse (1) the regional variation in incidence and referrals of adenoidectomies, tonsillectomies and ventilation tube insertions in children in the Netherlands between 2016 and 2019, (2) whether regional surgical rates, referral rates and in-hospital surgical rates were associated with one another, and (3) the hospital variation in healthcare costs, which indicates the utilisation of resources.DesignRepeated cross-sectional analysis.SettingFour neighbouring Dutch provinces comprising 2.8 million inhabitants and 14 hospitals.ParticipantsChildren aged 0–15 years.Outcome measuresWe analysed variation in regional surgical rates and referral rates per 1000 inhabitants and in-hospital surgical rates per 1000 clinic visitors, adjusted for age and socioeconomic status. Furthermore, the relationships between referral rates, regional surgical rates and in-hospital surgical rates were estimated. Lastly, variation in resource utilisation between hospitals was estimated.ResultsAdenoidectomy rates differed sixfold between regions. Twofold differences were observed for adenotonsillectomy rates, ventilation tube insertion rates and referral rates. Referral rates were negatively associated with in-hospital surgical rates for adenotonsillectomies, but not for adenoidectomies and ventilation tube insertions. In-hospital surgical rates were positively associated with regional rates for adenoidectomies and adenotonsillectomies. Significant variation between hospitals was observed in costs for all resources.ConclusionsWe observed low variation in tonsillectomies and ventilation tube insertion and high variation in adenoidectomies. Indications for a tonsillectomy and ventilation tube insertion are well defined in Dutch guidelines, whereas this is not the case for an adenoidectomy. Lack of agreement on indications can be expected and high-quality effectiveness research is required to improve evidence-based guidelines on this topic.

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Socio-Sexual Experiences and Access to Healthcare Among Informal PrEP Users in the Netherlands

AIDS and Behavior ◽

10.1007/s10461-020-03085-9 ◽

2020 ◽

Author(s):

Mart van Dijk ◽

John B. F. de Wit ◽

Rebecca Kamps ◽

Thomas E. Guadamuz ◽

Joel E. Martinez ◽

...

Keyword(s):

Sexual Behavior ◽

Qualitative Study ◽

The Netherlands ◽

Healthcare Providers ◽

Well Being ◽

Healthcare Services ◽

Interpretive Description ◽

Sex Partners ◽

Sex With Men ◽

Incorrect Information

AbstractThe aim of this qualitative study was to explore the experiences of informal PrEP users regarding access to PrEP and PrEP-related healthcare, community responses, sexual behavior and well-being. We interviewed 30 men who have sex with men (MSM) in semi-structured online interviews between March and August 2018. Interviews were analyzed using interpretive description. Informal PrEP users were well informed about the use of PrEP, but sometimes did not make use of renal testing. Participants reported a lack of PrEP knowledge among healthcare providers, which limited their access to PrEP and put them at risk, as they received incorrect information. Although some participants reported negative reactions from potential sex partners, most received positive reactions and were sometimes seen as more desirable sex partners. PrEP healthcare services should not only be accessible to formal PrEP users, but also to PrEP users who procure PrEP informally.

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Driving Factors for the Utilisation of Healthcare Services by People with Osteoarthritis: Results from A Nationwide Population-Based study

10.21203/rs.3.rs-279474/v1 ◽

2021 ◽

Author(s):

Daniela Costa ◽

Ana M Rodrigues ◽

Eduardo B Cruz ◽

Helena Canhão ◽

Jaime da Cunha Branco ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Multinomial Logistic Regression ◽

Healthcare Utilisation ◽

Healthcare Services ◽

Structured Interview ◽

Population Based ◽

Enabling Factors ◽

Population Based Study ◽

The Impact

Abstract Background: Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the profiles of healthcare services utilisation by people with knee osteoarthritis, and to analyse their determinants, according to Andersen’s behavioural model. Methods: We analysed a sample of 978 participants diagnosed with knee osteoarthritis from the population-based study EpiReumaPt . Data was collected with a structured interview, and the diagnosis of knee osteoarthritis was validated by a rheumatologist team. With the Two-step Cluster procedure, we primarily identified different profiles of healthcare utilisation according to the services most used by patients with knee osteoarthritis. Secondly, we analysed the determinants of each profile, using multinomial logistic regression, according to the predisposing characteristics, enabling factors and need variables.Results: In our sample, a high proportion of participants are overweight or obese (82,6%, n=748) and physically inactive (20,6%, n=201) and a small proportion had physiotherapy management (14,4%, n=141). We identified three profiles of healthcare utilisation: “HighUsers”; “GPUsers”; “LowUsers”. “HighUsers” represents more than 35% of the sample, and are also the participants with higher utilisation of medical appointments. "GPUsers" represent the participants with higher utilisation of general practitioner appointments. Within these profiles, age and geographic location – indicated as predisposing characteristics; employment status and healthcare insurance - as enabling factors; number of comorbidities, physical function, health-related quality of life, anxiety and physical exercise - as need variables, showed associations ( p <0,05) with the higher utilisation of healthcare services profiles. Conclusions: Healthcare utilisation by people with knee osteoarthritis is not driven only by clinical needs. The predisposing characteristics and enabling factors associated with healthcare utilisation reveal inequities in the access to healthcare and variability in the management of people with knee osteoarthritis. Research and implementation of whole-system strategies to improve equity in the access and quality of care are paramount in order to diminish the impact of osteoarthritis at individual-, societal- and economic-level.

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Assimilation of Ethnic-Religious Minorities in the Netherlands: A Historical-Sociological Analysis of Pre–World War II Jews and Contemporary Muslims

Social Science History ◽

10.1017/ssh.2017.12 ◽

2017 ◽

Vol 41 (3) ◽

pp. 477-504

Author(s):

Peter Tammes ◽

Peter Scholten

Keyword(s):

World War Ii ◽

The Netherlands ◽

Minority Groups ◽

Religious Affiliation ◽

Religious Practices ◽

Boundary Crossing ◽

Dutch Society ◽

World War ◽

And Behavior ◽

Pre World War Ii

This article examines what assimilation trajectories were manifest among present-day Mediterranean Muslims and pre–World War II Jews in Dutch society. Alba and Nee conceptualized assimilation in terms of processes of spanning and altering group boundaries, distinguishing between boundary crossing, blurring, and shifting. This study carves out to what extent assimilation processes like boundary crossing, shifting, and blurring had taken place for those two non-Christian minority groups in Dutch society. This research is based on findings of recent (quantitative) empirical research into the assimilation of pre–World War II Jews in the Netherlands and on the collection of comparable research and data for the assimilation of contemporary Mediterranean Muslims. Our study suggests that processes of boundary crossing, such as observance of religious practices and consumption of religious food, and blurring, such as intermarriage, residential segregation, and religious affiliation, are much less advanced for Mediterranean Muslims in the present time. Though several factors might account for differences in boundary-altering processes between pre–World War II Jews and contemporary Mediterranean Muslims such as differences in length of stay in the Netherlands, the secularization process, and globalization, Jewish assimilation might provide us some reflections on assimilation of Mediterranean Muslims. The continuous arrival of Muslim newcomers might affect attitudes and behavior of settled Mediterranean Muslims, while policy to restrict family migration might be insufficient to stimulate Muslims to integrate in Dutch society given the quite negative mutual perceptions, the slow process of residential spreading, the continuation of observance of religious practices, and the low intermarriage rate.

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