Department of Epidemiology, Documentation and Health Promotion, Municipal Health Service, 1000 CE Amsterdam, The Netherlands.
Gen Hosp Psychiatry. 2010 Jul-Aug;32(4):368-76. doi: 10.1016/j.genhosppsych.2010.04.010.
There is widespread concern about access to good quality health care for ethnic minority groups. This study investigates differences between ethnic groups regarding prevalence of anxiety and depression, and adherence to treatment guidelines by family practitioners in urban areas in the Netherlands.
Data from electronic medical records, collected for the Netherlands Information Network of General Practice. Diagnoses were based on the International Classification of Primary Care. Adherence to guidelines included at least five consultations, prescription of psychotropics for 6 weeks at most (indicative of cessation in case of nonresponse) or 5 months at least (suggesting continuation in case of response), and/or a referral to a mental health care specialist. Data were analyzed using multilevel logistic regression analyses.
A total of 6413 patients (4.4% of practice population) were diagnosed with anxiety and/or depression. Prevalence was highest in Turkish patients (5.2%). Of diagnosed patients, 42.9% received guideline-concordant treatment. Only Surinamese/Antillean patients were less likely than ethnic Dutch to receive treatments according to guidelines.
Prevalence of and quality of care for anxiety and depression were comparable between ethnic minority clients, but some differences suggest that efforts to educate primary care providers in management of anxiety/depression should be continued and tailored to specific ethnic groups.
人们普遍关注少数民族获得高质量医疗保健的问题。本研究调查了荷兰城市地区族裔群体之间焦虑和抑郁的患病率差异,以及家庭医生对治疗指南的遵循情况。
数据来自荷兰普通实践信息网络的电子病历。诊断基于初级保健国际分类。对指南的遵守情况包括至少 5 次咨询、最多 6 周(提示无反应时停药)或至少 5 个月(提示有反应时继续用药)的精神药物处方,以及/或向精神卫生专家转介。使用多水平逻辑回归分析对数据进行分析。
共有 6413 名患者(占实践人群的 4.4%)被诊断患有焦虑症和/或抑郁症。土耳其患者的患病率最高(5.2%)。在被诊断出患有这些疾病的患者中,有 42.9%接受了符合指南的治疗。只有苏里南/荷属安的列斯群岛的患者比荷兰族裔患者更不可能按照指南接受治疗。
焦虑和抑郁的患病率和治疗质量在少数民族患者之间相当,但一些差异表明,应继续努力教育初级保健提供者如何管理焦虑/抑郁,并针对特定的族裔群体进行调整。