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A comparison of general practice encounters with patients from English-speaking and non-English-speaking backgrounds
Stephanie A Knox1, Helena Britt
1General Practice Statistics and Classification Unit, Acacia House, Westmead Hospital, PO Box 533, Wentworthville, NSW 2145, Australia. sknox@med.usyd.edu.au
Objective:
To determine whether doctor-patient encounters in general practice with patients from a non-English-speaking background (NESB) differ from encounters with patients of English-speaking background (ESB) in terms of the type of practice where the encounters occur and the type of problems managed.
Design And Setting:
A national cross-sectional survey of GP-patient encounters from a sample of all active registered GPs in Australia.
Participants:
A random sample of 1047 GPs recruited in the 12 months from April 1999 to March 2000, each providing details of 100 consecutive patient encounters.
Main Outcome Measures:
GP demographics, practice characteristics, patient demographics (including whether the patient mainly spoke a language other than English at home), and problems managed at the encounter.
Results:
After adjusting for significant predictors, encounters with NESB patients were significantly more likely to occur at solo practices than practices of five or more GPs (odds ratio [OR], 2.15; 95% CI, 1.49-3.09), in metropolitan practices (OR, 6.34; 95% CI, 4.04-9.96), and with GPs who mostly consulted in a language other than English (OR, 5.44; 95% CI, 3.78-7.83). NESB encounters were relatively more likely to involve a respiratory problem (OR, 1.14; 95% CI, 1.04-1.26), endocrine/metabolic problem (OR, 1.41; 95% CI, 1.22-1.63) or digestive problem (OR, 1.14; 95% CI, 1.02-1.27), and relatively less likely to involve a psychological problem (OR, 0.73; 95% CI, 0.61-0.88) or social problem (OR, 0.67; 95% CI, 0.49-0.92).
Conclusion:
Differences in morbidity management rates between encounters with NESB patients and ESB patients may reflect both differences in underlying prevalences of some disorders in the population of general practice patients, as well as different reasons among the two groups for attending general practice.
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