荷兰家庭医疗中患慢性病的无证和有证移民。

Undocumented and documented migrants with chronic diseases in Family Practice in the Netherlands.

作者信息

van de Sande Jonathan S O, van den Muijsenbergh Maria E T C

机构信息

Medical resident Department of Cardiology, Rijnstate Arnhem, at the time of research Medical Student, Radboudumc, Nijmegen, The Netherlands.

Department of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands.

出版信息

Fam Pract. 2017 Nov 16;34(6):649-655. doi: 10.1093/fampra/cmx032.

DOI:10.1093/fampra/cmx032

PMID:28444317

Abstract

BACKGROUND

Undocumented migrants (UM) face many barriers in accessing healthcare. It is unknown how these affect the care of UM with chronic diseases in general practices. In the Netherlands, a General practitioner (GP) is the gatekeeper to the healthcare system and primary care provider for UM.

OBJECTIVE

To get insight into GP care for chronic diseases in UM compared with documented migrants (DM).

METHODS

A survey study of medical records of UM and DM in five general practices in the Netherlands with extensive experience in caring for UM. UM and DM were matched for gender, age and region of origin. Consultation rates, values of HbA1C, blood pressure, spirometry, number of referrals and medicine prescriptions were compared in all people with cardiovascular disease, diabetes or asthma/ COPD.

RESULTS

In overall, 729 migrants were included (407 UM and 322 DM). UM consulted their GP significantly less often than DM (3.24 versus 5.04 times a year). UM with cardiovascular disease had a slightly higher blood pressure (148.1 versus 140.8 mmHg), and UM with diabetes had their blood pressure checked less frequently (0.70 versus 1.95 times a year). Overall however, the differences between UM and DM with chronic diseases were small.

CONCLUSION

Undocumented migrants with chronic diseases in general practices in the Netherlands that are experienced in caring for UM receive to a large extent equitable care compared to documented migrants.

摘要

背景

无证移民在获得医疗保健方面面临诸多障碍。目前尚不清楚这些障碍如何影响全科医疗中患有慢性病的无证移民的护理。在荷兰，全科医生是医疗保健系统的守门人以及无证移民的初级护理提供者。

目的

了解与有证件移民相比，全科医生对无证移民慢性病的护理情况。

方法

对荷兰五家在护理无证移民方面经验丰富的全科诊所中无证移民和有证件移民的病历进行调查研究。无证移民和有证件移民在性别、年龄和原籍地区方面进行了匹配。对所有患有心血管疾病、糖尿病或哮喘/慢性阻塞性肺病的人，比较了他们的就诊率、糖化血红蛋白值、血压、肺活量测定结果、转诊次数和药物处方数量。

结果

总共纳入了729名移民（407名无证移民和322名有证件移民）。无证移民咨询全科医生的频率明显低于有证件移民（每年3.24次对5.04次）。患有心血管疾病的无证移民血压略高（148.1对140.8毫米汞柱），患有糖尿病的无证移民血压检查频率较低（每年0.70次对1.95次）。然而总体而言，患有慢性病的无证移民和有证件移民之间的差异较小。