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. Key words: chronic disease, general practice, general practitioners, health care access, health care evaluation, health care quality, physicians, primary care, undocumented immigrants. Introduction under 40 years (3), originating from Sub-Saharan Africa and Asia (including the Middle-East) (3), of whom 11–33% entered the coun- In the European Union, between 2.8 and 6 million people do not try as asylum seeker. Many of them live in difficult circumstances, possess a legal residence permit for their country of residence (1). characterized by harsh working and living conditions (4). Detailed These so called undocumented migrants (UM) include people who information about their socio-economic situation is difficult to get, overstay their visa, rejected asylum seekers and individuals who have due to the large variety in UM characteristics and their illegal staentered a country illegally (2). tus. But in general, their socio-economic status is low. They rate The number of UM in Netherlands is estimated to be between their health much lower than migrants who are legally residing in 62.320 and 113.912 (3). The UM in the Netherlands are mostly men © The Author 2017. 649 For permissions, please e-mail: journals.permissions@oup.com. 650 Family Practice, 2017, Vol. 34, No. 6 European countries (documented migrants, hereafter DM) (4) and Selection of