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Quality of primary care for resettled refugees in the Netherlands with chronic mental and physical health problems: a cross-sectional analysis of medical records and interview data.

van Melle MA, Lamkaddem M, Stuiver MM, Gerritsen AA, Devillé WL, Essink-Bot ML - BMC Fam Pract (2014)

Bottom Line: GP recognition of CMD was calculated as the number of CMD cases registered in the medical record compared with those found in interviews.Thirty-five out of these 53 (66%) resettled refugees with chronic mental and non-communicable disorders received guideline-adherent treatment.This study shows that awareness in resettled refugees of GP diagnosed DMII and HT is high, whereas GP recognition of CMD and overall guideline adherence are moderate.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.a.vanmelle-2@umcutrecht.nl.

ABSTRACT

Background: A high prevalence of mental and physical ill health among refugees resettled in the Netherlands has been reported. With this study we aim to assess the quality of primary healthcare for resettled refugees in the Netherlands with chronic mental and non-communicable health problems, we examined: a) general practitioners' (GP) recognition of common mental disorders (CMD) (depression and anxiety, and post-traumatic stress disorder (PTSD) symptoms); b) patients' awareness of diabetes type II (DMII) and hypertension (HT); and c) GPs' adherence to guidelines for CMD, DMII and HT.

Methods: From 172 refugees resettled in the Netherlands, interview data (2010-2011) and medical records (n = 106), were examined. Inclusion was based on medical record diagnoses for DMII and HT, and on questionnaire-based CMD measures (Hopkins Symptom Checklist for depression and anxiety; Harvard Trauma Questionnaire for PTSD). GP recognition of CMD was calculated as the number of CMD cases registered in the medical record compared with those found in interviews. Patient awareness of HT and DMII was scored as the percentage of subjects diagnosed by the GP who reported their condition during the interview. GPs' adherence to guidelines for CMD, DMII and HT was measured using established indicators.

Results: We identified 37 resettled refugees with CMD of which 18 (49%) had been recognised by the GP. We identified 16 refugees with DMII and 14 with HT from the medical record; 24 (80%) were aware of their condition. Thirty-five out of these 53 (66%) resettled refugees with chronic mental and non-communicable disorders received guideline-adherent treatment.

Conclusion: This study shows that awareness in resettled refugees of GP diagnosed DMII and HT is high, whereas GP recognition of CMD and overall guideline adherence are moderate.

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Related in: MedlinePlus

Patient identification and measurement of cases. For Common Mental Disorders, cases are selected in the interview and compared to the medical record (GP-recognition). Diabetes type II (DMII) and Hypertension (HT) cases are selected in the medical record and compared to the interview (patient-awareness).
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Fig2: Patient identification and measurement of cases. For Common Mental Disorders, cases are selected in the interview and compared to the medical record (GP-recognition). Diabetes type II (DMII) and Hypertension (HT) cases are selected in the medical record and compared to the interview (patient-awareness).

Mentions: This study focused on CMD, DMII and HT because of the widely accepted quality indicators for treatment and because of the high prevalence of these conditions among the present study population. Figure 2 shows the process of patient identification, data extraction and analysis for CMD, DMII and HT.Figure 2


Quality of primary care for resettled refugees in the Netherlands with chronic mental and physical health problems: a cross-sectional analysis of medical records and interview data.

van Melle MA, Lamkaddem M, Stuiver MM, Gerritsen AA, Devillé WL, Essink-Bot ML - BMC Fam Pract (2014)

Patient identification and measurement of cases. For Common Mental Disorders, cases are selected in the interview and compared to the medical record (GP-recognition). Diabetes type II (DMII) and Hypertension (HT) cases are selected in the medical record and compared to the interview (patient-awareness).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4262989&req=5

Fig2: Patient identification and measurement of cases. For Common Mental Disorders, cases are selected in the interview and compared to the medical record (GP-recognition). Diabetes type II (DMII) and Hypertension (HT) cases are selected in the medical record and compared to the interview (patient-awareness).
Mentions: This study focused on CMD, DMII and HT because of the widely accepted quality indicators for treatment and because of the high prevalence of these conditions among the present study population. Figure 2 shows the process of patient identification, data extraction and analysis for CMD, DMII and HT.Figure 2

Bottom Line: GP recognition of CMD was calculated as the number of CMD cases registered in the medical record compared with those found in interviews.Thirty-five out of these 53 (66%) resettled refugees with chronic mental and non-communicable disorders received guideline-adherent treatment.This study shows that awareness in resettled refugees of GP diagnosed DMII and HT is high, whereas GP recognition of CMD and overall guideline adherence are moderate.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.a.vanmelle-2@umcutrecht.nl.

ABSTRACT

Background: A high prevalence of mental and physical ill health among refugees resettled in the Netherlands has been reported. With this study we aim to assess the quality of primary healthcare for resettled refugees in the Netherlands with chronic mental and non-communicable health problems, we examined: a) general practitioners' (GP) recognition of common mental disorders (CMD) (depression and anxiety, and post-traumatic stress disorder (PTSD) symptoms); b) patients' awareness of diabetes type II (DMII) and hypertension (HT); and c) GPs' adherence to guidelines for CMD, DMII and HT.

Methods: From 172 refugees resettled in the Netherlands, interview data (2010-2011) and medical records (n = 106), were examined. Inclusion was based on medical record diagnoses for DMII and HT, and on questionnaire-based CMD measures (Hopkins Symptom Checklist for depression and anxiety; Harvard Trauma Questionnaire for PTSD). GP recognition of CMD was calculated as the number of CMD cases registered in the medical record compared with those found in interviews. Patient awareness of HT and DMII was scored as the percentage of subjects diagnosed by the GP who reported their condition during the interview. GPs' adherence to guidelines for CMD, DMII and HT was measured using established indicators.

Results: We identified 37 resettled refugees with CMD of which 18 (49%) had been recognised by the GP. We identified 16 refugees with DMII and 14 with HT from the medical record; 24 (80%) were aware of their condition. Thirty-five out of these 53 (66%) resettled refugees with chronic mental and non-communicable disorders received guideline-adherent treatment.

Conclusion: This study shows that awareness in resettled refugees of GP diagnosed DMII and HT is high, whereas GP recognition of CMD and overall guideline adherence are moderate.

Show MeSH
Related in: MedlinePlus