L von Ferber1, I Köster, N Celayir-Erdogan. 1. Forschungsgruppe Primärmedizinische Versorgung an der Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Klinikum der Universität zu Köln, Cologne. Liselotte.vonFerber@medizin.uni-koeln.de
Abstract
AIM OF THE STUDY: to assess the diseases and complaints and the concepts for treatment of patients and drug prescriptions relative to their ethnic origin: Turkish immigrants (T) or German citizens (D). METHODS: Questionnaire survey of patients of general practitioners before and after consultation. The survey was conducted separately for Turkish and German patients, involving nine GP's practices for each group. Sample sizes were 253 Turkish and 637 German patients, respectively. Only responses of patients younger than 60 years of age were evaluated (T: 216/G: 357). Reason: Relative to the entire Turkish population in Germany the number of ethnic Turks older than 60 is too small for comparative purposes. RESULTS: The two most frequent reasons for a visit to the doctor by Turkish migrants were pain of varied origin (T: 44 % / G: 21 %; p > 0.001) and colds or diseases of the respiratory tract (T: 41 % / G: 25 %; p > 0.001). Turkish and German patients differ significantly with respect to their mentioning of pain and colds. The concept of treatment of the Turkish patients is compared to German patients more adjusted to medicaments and less to counselling and discussion with the doctor. The physicians' prescribing frequency on the other hand conforms primarily to the disease of the patients and not to their ethnic group. To confirm this, compare the share of drug recipients per disease group: Respiratory tract: T: 79 % / D: 84 %, alimentary system: T: 58 % / D: 60 % and locomotor system: T: 49 % / D: 39 %. Secondly the physicians' prescribing frequency conforms to the patients' expectations of medicaments: Of the patients who expected a prescription T: 79 % and D: 77 % respectively were given a prescription and of those who did not expect a prescription T: 55 % / D: 51 % did receive it. Again the patients' ethnic group had no influence on the prescribing frequency. Significantly more Turkish than German patients (T: 23 % / D: 9 %; p < 0.001) received pain-relieving drugs. This is especially true for Turkish patients with illnesses of the respiratory, alimentary and locomotor system. This is the explanation: More Turkish than German patients name pain as their consulting reason. Again the prescribing frequency does not depend on the ethnic group. It depends on the patient' s pain. CONSEQUENCES: The treatment concept of Turkish patients is more directed to drugs. They request a drug more intensively and are more convinced of the medicaments' effectiveness than German patients are. In spite of this, physicians give a prescription according to the indication of the patient independent of his ethnic origin. The insistence on a prescription is significantly higher in Turkish than in German patients.
AIM OF THE STUDY: to assess the diseases and complaints and the concepts for treatment of patients and drug prescriptions relative to their ethnic origin: Turkish immigrants (T) or German citizens (D). METHODS: Questionnaire survey of patients of general practitioners before and after consultation. The survey was conducted separately for Turkish and German patients, involving nine GP's practices for each group. Sample sizes were 253 Turkish and 637 German patients, respectively. Only responses of patients younger than 60 years of age were evaluated (T: 216/G: 357). Reason: Relative to the entire Turkish population in Germany the number of ethnic Turks older than 60 is too small for comparative purposes. RESULTS: The two most frequent reasons for a visit to the doctor by Turkish migrants were pain of varied origin (T: 44 % / G: 21 %; p > 0.001) and colds or diseases of the respiratory tract (T: 41 % / G: 25 %; p > 0.001). Turkish and German patients differ significantly with respect to their mentioning of pain and colds. The concept of treatment of the Turkish patients is compared to German patients more adjusted to medicaments and less to counselling and discussion with the doctor. The physicians' prescribing frequency on the other hand conforms primarily to the disease of the patients and not to their ethnic group. To confirm this, compare the share of drug recipients per disease group: Respiratory tract: T: 79 % / D: 84 %, alimentary system: T: 58 % / D: 60 % and locomotor system: T: 49 % / D: 39 %. Secondly the physicians' prescribing frequency conforms to the patients' expectations of medicaments: Of the patients who expected a prescription T: 79 % and D: 77 % respectively were given a prescription and of those who did not expect a prescription T: 55 % / D: 51 % did receive it. Again the patients' ethnic group had no influence on the prescribing frequency. Significantly more Turkish than German patients (T: 23 % / D: 9 %; p < 0.001) received pain-relieving drugs. This is especially true for Turkish patients with illnesses of the respiratory, alimentary and locomotor system. This is the explanation: More Turkish than German patients name pain as their consulting reason. Again the prescribing frequency does not depend on the ethnic group. It depends on the patient' s pain. CONSEQUENCES: The treatment concept of Turkish patients is more directed to drugs. They request a drug more intensively and are more convinced of the medicaments' effectiveness than German patients are. In spite of this, physicians give a prescription according to the indication of the patient independent of his ethnic origin. The insistence on a prescription is significantly higher in Turkish than in German patients.