Visscher, J. (Jordi) (2019) ONDERBROKEN CONTINUITEIT VAN EERSTELIJNS ZORG IN NEDERLAND VOOR VLUCHTELINGEN; KENNISGEBREK EN WANTROUWEN. thesis, Medicine.
Full text available on request.Abstract
Literature shows that refugees have higher health risks than others and there are clues that the continuity of (primary) care for these status holders in the Netherlands remains bogged on multiple levels. This research identified where certain limitations for status holders are emerging and recommendations were offered to lessen these. By means of quantitative research (questionnaires) and qualitative in-depth interviews we investigated to what extent status holders are registered with a primary physician (family doctor) and what difficulties are in their continuity of care. Interview transcripts were analyzed and status holder groups were compared using regression analysis models on factors that possibly influence registration with a primary physician. Altogether 139 status holders filled in the questionnaire (89 Syrian, 39 Eritrean, 11 other). Ninety-two (67%) respondents had a primary physician within 3 months. Overall 95% of participating status holders were registered with a primary physician. A lower education level and not receiving (voluntary) aid correlated with no or late (>3 months) registration with a primary physician (respectively OR 0.32, 95% CI 0.18-0.96 and OR 0.35, 95% CI 0.16-0.74). More than half of the approached general practices (56%) lacked the knowledge how to request medical files from the asylum seekers center, resulting in 75% of missing status holder’s files. In-depth interviews with medical professionals (N=11) and status holders (aged 24-51, N=12) revealed that registration with a primary physician does not necessarily correlate with better continuity of care. Differences in health care systems, lacking provision of information and mistrusting the Dutch primary physician impede the continuity of (primary) care. Existing information reaches status holders insufficiently and they often feel “abandoned to their fate”. In conclusion are most status holders registered with a primary physician. Nevertheless there are several problems regarding continuity of care. Recommendations resulting from this research are: (1) keep adapting to existing language and culture barriers, (2) implement a national, migrant sensitive, mandatory ‘healthcare integration program’ and (3) actualize better transfer of information between asylum seekers center and primary physician.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Stienstra, Mw prof dr Y. |
| Supervisor name: | Boogaard, Mw. dr Jossy van den |
| Faculty: | Medical Sciences |
| Date Deposited: | 02 Oct 2020 10:05 |
| Last Modified: | 02 Oct 2020 10:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2768 |
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