1Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Scand J Public Health. 2012 Feb;40(1):25-34. doi: 10.1177/1403494811425710. Epub 2011 Oct 19.
This study examines the mechanisms responsible for ethnic differences in perceived quality of care in The Netherlands. The specific role of cultural attitudes, language proficiency, and the health system in the country of origin was examined, taking socio-demographic characteristics into account.
Interview data of 1339 respondents of Moroccan, Turkish, Surinamese and Antillean origin were combined with interview data of Dutch respondents (n = 405) and of Western immigrants (n = 102) in The Netherlands and of a random sample of Dutch privately or publicly insured persons (n = 9675). Data collection took place within the Second Dutch National Survey of General Practice (DNSGP-2, 2001). Items from the QUality Of care Through the patient's Eyes (QUOTE) questionnaire were used to measure expectations, as well as items from the QUOTE-Mi (adapted version for migrant groups). Items on normative orientations were used to measure cultural attitudes.
In contrast to our hypothesis, respondents with more egalitarian/modern attitudes attached less importance to quality aspects related to access and quality. Tests on the role of the health system of reference were generally conclusive, showing that respondents accustomed to (parts of) another system have different expectations regarding several aspects of general practitioner healthcare quality, e.g. access to specialist care.
Besides socio-demographic characteristics, culture influences patients' expectations regarding general practitioner care quality. However, the role of culture can be more clearly ascribed to the characteristics of the health system which is held as the reference than to the general attitudes on normative orientations.
本研究旨在探讨荷兰不同族裔感知医疗质量差异的原因。本研究考虑了社会人口特征，考察了文化态度、语言能力以及原籍国卫生系统在其中的具体作用。
将 1339 名摩洛哥裔、土耳其裔、苏里南裔和荷属安的列斯裔受访者的访谈数据与荷兰受访者（n=405）、荷兰西方移民（n=102）以及荷兰私人或公共保险人员的随机样本（n=9675）的访谈数据相结合。数据收集于 2001 年第二次荷兰全科医疗调查（DNSGP-2）中。使用 QUality Of care Through the patient's Eyes（QUOTE）问卷中的项目来衡量期望，以及 QUOTE-Mi（适用于移民群体的改编版）中的项目。规范性取向的项目用于衡量文化态度。
与我们的假设相反，具有更平等/现代态度的受访者对与获得和质量相关的质量方面不太重视。对参考卫生系统作用的测试通常具有结论性，表明习惯于（部分）另一种系统的受访者对全科医生医疗质量的几个方面有不同的期望，例如获得专科护理的机会。
除了社会人口特征外，文化也会影响患者对全科医生护理质量的期望。然而，文化的作用可以更明确地归因于被视为参考的卫生系统的特征，而不是规范性取向的一般态度。
