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Healthcare utilisation among migrants in the Netherlands’ unique hybrid healthcare system

The Helius study

Bibliographic Data

ID21879698
AuthorsMary Cassidy (Public Health Service of Amsterdam), Charles Agyemang (0000-0002-3882-7295, Public Health Service of Amsterdam), H Galenkamp (0000-0002-5904-3465, Public Health Service of Amsterdam), Eric Moll van Charante (Public Health Service of Amsterdam), Felix P Chilunga (0000-0003-4083-001X, Public Health Service of Amsterdam)
Year2026
Volume11
Issue3
Pagese020024
Publication date2026-03-01
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2025-020024
PMID41839528
OpenAlexW7137374148
LanguageEN
References cited24

BACKGROUND: Migrants in Europe often face barriers to healthcare, contributing to poorer health outcomes. While healthcare utilisation has been studied within Beveridge systems (eg, the UK) and Bismarck systems (eg, Germany), less is known about healthcare use by migrants within the Netherlands' hybrid model. The Dutch model combines a Bismarckian base with Beveridge-like supplements. We investigated the use of general practitioner (GP) services, specialist care, allied health services and complementary medicine among major migrant groups in Amsterdam (South Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin) compared with the Dutch-origin population. METHODS: We used pre-pandemic Healthy Life in an Urban Setting data (2015; n=21 614) to avoid biases from intra-COVID-19 and post-COVID-19 healthcare disruptions/alterations. Structured questionnaires assessed healthcare use and reasons for seeking care. Poisson regression with a log link and robust (sandwich) standard errors examined associations between migration background and healthcare utilisation, adjusting for demographics, acculturation, health literacy, lifestyle and chronic conditions. Sensitivity analyses explored motivations for care use and overall health status. RESULTS: All migrant groups reported higher or similar use of GP services compared with the Dutch-origin population. Most migrant groups (except Ghanaians) also reported higher or similar use of specialist and allied health services. Conversely, use of complementary medicine was higher among Dutch-origin participants than among migrants. CONCLUSION: Many migrant groups in Amsterdam show higher use of mainstream healthcare services compared with previous reports from other European settings. Further studies should examine and dissect these patterns to inform improvements in other European settings

Health care · Health services research · Healthcare service · Healthcare system · Immigration · Mainstream · Poisson regression · Turkish · Global Health Workforce Issues · Global Healthcare and Medical Tourism · Migration, Health and Trauma

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