Ethnicity as a risk factor for consultations in primary health care and out-patient care

OBJECTIVE: To determine the influence of ethnicity, defined as foreign-born people, on consultation rates, admissions and prescriptions in out-patient care and primary health care. DESIGN: Prospective study of attenders at four different caregivers during seven consecutive weeks in 1988. Age-and sex-standardized relative risks and odds ratios with 95% confidence interval were calculated. SETTING: A suburban area in Lund, a city located in the south of Sweden, with 28% foreign-born people. SUBJECTS: This population (N = 5085) made 1,348 consultations. MAIN OUTCOME MEASURES: Ethnic group and consultation rates of the local primary health care centre, the emergency department, hospital out-patient department, and private care, admissions to specialist care, prescriptions, and certified sick leave. RESULTS: Swedes made fewer age-and sex-standardized visits to the emergency department (RR = 0.69(0.48-0.99)) while the foreign-born people showed an opposite non-significant trend (RR = 1.37(0.95-1.99)). Latin Americans (RR = 1.60(1.02-2.51)) visited the local Primary Health Care centre in the residential area more than expected, while people born in Asia and Africa consulted the Primary Health Care centre less than expected (RR = 0.44(0.28-0.69)). There were no differences between Swedes and foreign-born people in being put on the sick-list, but foreign-born people were given significantly fewer prescriptions (RR = 0.07(0.03-0.19)) than Swedes. Foreign-born people, Latin Americans, and non-Swedish Scandinavians were referred significantly more often to hospital than other groups. CONCLUSIONS: There were important differences in consultations between Swedes and foreign-born people. It seems important to study these differences further to find out if they were due to morbidity or cultural differences in order to be able to meet the demands and needs of different ethnic groups.