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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Family Practice 1/2014

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

BMC Family Practice > Ausgabe 1/2014
Marije A van Melle, Majda Lamkaddem, Martijn M Stuiver, Annette AM Gerritsen, Walter LJM Devillé, Marie-Louise Essink-Bot
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2296-15-160) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

MM, ML, MS, AG, WD and ME conceived the study. MM developed the protocol. ML and ME closely supervised the protocol development. MS contributed to the protocol development. MM retrieved the data from medical records. MM analysed the data, interpreted the results and wrote the first draft of the manuscript. ML and ME supervised the analysis and interpretation of the results. All authors participated in reviewing and editing of various drafts of the manuscript and they all read and approved the final manuscript.



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.


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.


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.


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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