Ignorance is not bliss: The effect of systematic information on immigrants' knowledge of and satisfaction with the Danish healthcare system

TY - JOUR

T1 - Ignorance is not bliss

T2 - The effect of systematic information on immigrants' knowledge of and satisfaction with the Danish healthcare system

AU - Jervelund, Signe Smith

AU - Maltesen, Thomas

AU - Wimmelmann, Camilla Lawaetz

AU - Petersen, Jørgen Holm

AU - Krasnik, Allan

N1 - Del af SULIM projektet (www.sulim.ku.dk)

PY - 2017/3/1

Y1 - 2017/3/1

N2 - AIMS: Suboptimal healthcare utilisation and lower satisfaction with the patient-doctor encounter among immigrants has been documented. Immigrants' lack of familiarity with the healthcare system has been proposed as an explanation for this. This study investigated whether a systematic delivery of information affected immigrants' knowledge of and satisfaction with the Danish healthcare system.METHODS: A prospective, randomised intervention study of 1158 adult immigrants attending two language schools in Copenhagen was conducted. Two intervention groups received written information or a 12-hour course on the Danish healthcare system, while a control group received nothing. Survey data included self-assessed knowledge, true/false questions on access and questions relating to satisfaction with the healthcare system. Data were linked to socioeconomic registry data. Logistic regression analyses were performed.RESULTS: The course improved knowledge of who to contact in the event of an accident (odds ratio (OR) = 2.67, 95% confidence interval (CI) = 1.56-4.59) but not in the event of illness. Further, it positively affected correct answers for nine out of 11 questions on the healthcare system (varying from OR = 1.87, 95% CI = 1.08-3.24 to OR = 3.11, 95% CI = 1.58-6.11). Written information positively affected correct answers for three out of 11 questions, but negatively affected one out of 11 compared with the control group. Neither intervention affected immigrants' satisfaction with the healthcare system.CONCLUSIONS: Knowledge of the healthcare system is necessary for optimal healthcare-seeking behaviour. The results may form the basis of national and international changes in immigrant reception and optimise immigrants' contact with the healthcare system.

AB - AIMS: Suboptimal healthcare utilisation and lower satisfaction with the patient-doctor encounter among immigrants has been documented. Immigrants' lack of familiarity with the healthcare system has been proposed as an explanation for this. This study investigated whether a systematic delivery of information affected immigrants' knowledge of and satisfaction with the Danish healthcare system.METHODS: A prospective, randomised intervention study of 1158 adult immigrants attending two language schools in Copenhagen was conducted. Two intervention groups received written information or a 12-hour course on the Danish healthcare system, while a control group received nothing. Survey data included self-assessed knowledge, true/false questions on access and questions relating to satisfaction with the healthcare system. Data were linked to socioeconomic registry data. Logistic regression analyses were performed.RESULTS: The course improved knowledge of who to contact in the event of an accident (odds ratio (OR) = 2.67, 95% confidence interval (CI) = 1.56-4.59) but not in the event of illness. Further, it positively affected correct answers for nine out of 11 questions on the healthcare system (varying from OR = 1.87, 95% CI = 1.08-3.24 to OR = 3.11, 95% CI = 1.58-6.11). Written information positively affected correct answers for three out of 11 questions, but negatively affected one out of 11 compared with the control group. Neither intervention affected immigrants' satisfaction with the healthcare system.CONCLUSIONS: Knowledge of the healthcare system is necessary for optimal healthcare-seeking behaviour. The results may form the basis of national and international changes in immigrant reception and optimise immigrants' contact with the healthcare system.

KW - Faculty of Health and Medical Sciences

KW - indvandrere

KW - flygtninge

KW - sundhedsvæsenet

KW - intervention

KW - tilfredshed

KW - viden

KW - effekt

KW - sprogskoler

KW - innovation

KW - SULIM

U2 - 10.1177/1403494816685936

DO - 10.1177/1403494816685936

M3 - Journal article

C2 - 28077059

SN - 1403-4948

VL - 45

SP - 161

EP - 174

JO - Scandinavian Journal of Public Health

JF - Scandinavian Journal of Public Health

IS - 2

ER -