Patterns of health care utilization in Curacao

This paper describes the epidemiology of health care utilization in Curacao. The data presented are derived from the Curacao Heatlh Study, a health interview survey among a representative sample of the adult non-institutionalized population (n=2 248) which was carried out in 1993-1994. The outcome is compared to data on health care utilization in The Netherlands in 1994. In general, the use of GPs, specialists and hospitals in Curacao is fairly similar to that of The Netherlands, but the use of dentists and physiotherapists is markedly lower in Curacao. Some distinct differences in utilization of health services between the various population groups are revealed by the data presented in this paper. Women have a higher average level of health services utilization than men, which is in accordance with the fact that in general women's health status is somewhat less good than that of men. Older people make more use of specialists and district nursing care, and are more often hospitalized than young and middle-aged people. This is not surprising, in view of the fact, that in general aging is accompanied by a deterioration in health and a greater need for medical care. In this light, it is striking that older people do not make more use of the services of GPs than younger individuals (AU)

A health profile of Curacao: results from the Curacao health study - abstract

Based on the outcomes of the Curacao Health Study, a health profile of the adult non-institutionalized population of Curacao was drawn. A randomly drawn sample of 2248 participants has been surveyed in face-to-face interviews. Data were collected on the prevalence of chronic disorders and functional limitations, and on the subjects' self-perceived health. Of the total sample 58.8 percent reported to be suffering from one or more chronic disorders. The most prevalent chronic conditions are hypertension (14.5 percent), arthrosis and arthritis (11.1 percent), dizziness (10.85 percent), chronic back problems (10.1 percent) and psychological problems (9.6 percent). As regards functional limitations, 4.7 percent of the total sample have very serious visual disabilities and 1.4 percent are (practically) deaf; the prevalence of limitations in activities of daily living can be estimated at 0.3 to 2.8 percent, depending on the kind of activities that are taken as a criterion. A general conclusion is that women, the elderly and individuals from the lower socio-economic strata (SES) are relatively disadvantaged as regards health. The disadvantage for women and individuals from the lower SES applies to both their physical and their mental health. Ageing is soley related to a worsening of the physical health status. The subjective health perceptions of the participants are in accordance with their more objective health status; women, individuals from the lower SES and the elderly have a relatively poorer perceived health. The particular value of these profiles lies in their usefulness for the establishment of priority areas in health policy, by identifying relatively disadvantaged groups who need specific attention (AU)

The Curacao health study: cross-cultural use of a health survey; results from the pilot study - abstract

A health survey offers a unique opportunity to explore the health-related needs of a population by collecting complete, comprehensive and integrated information on health, health-related behaviour and sociodemographic factors. Preparatory to a large-scale health survey on Curacao, a pilot study was carried out. The instruments used include measures of health status, lifestyle, use of conventional and traditional medicine, health-related attitudes and knowledge, as well as personal characteristics and characteristics of social relations. For this pilot study, the questionnaire was translated into Dutch and Papiamento. For the main study, English and Spanish versions will also be available. The questionnaire has been tested in face-to-face interviews with 134 individuals aged 18-90 years, randomly selected from the Registry Office. The willingness of the population to participate in the survey was remarkably high. The interview protocol has been evaluated, and the psychometric properties of the instruments have been determined. The experiences with the interview protocol are generally positive, and the psychometric analyses show that most instruments yield valid and reliable information. The overall conclusion is that, when adapting the survey design to the specific conditions of a multilingual community with a large variation in socio-economic levels, a health survey in Curacao is feasible and that a useful and relevant instrument is available (AU)

Socio-economic health differences in Curacao: results from the pilot of the Curacao health study - abstract

The objective of the current study is to investigate whether the data collected in the pilot of the Curacao Health Study could be used to determine possible socio-economic health differences in Curacao. In order to do this, secondary analyses were performed on data from a sample of 134 persons. In males there appeared to be a difference between higher versus lower educated groups with respect to the total number of chronic complaints and perceived general health. In addition, males without access to a car reported a poorer general health compared to the group that does have access to a car. In females, these differences were not significant. However, females reported on the average more chronic diseases, more short-term complaints, worse physical functioning and a poorer general health compared to males. Because of the small sample size no definite statements on socio-economic health differences in Curacao can be made, although the type of data collected proved not only useful but necessary to conduct further investigation in this matter (AU)