Abstract
INTRODUCTION: Indigenous peoples tend to differ from their non-Indigenous counterparts in use of health care services. Lack of available services, socioeconomic disparities, communication barriers and lack of trust have been found to be barriers driving the observed differences. AIM: The aim of this study is to investigate ethnic differences in the use of assigned general practitioner and emergency health care (2012-2019) while adjusting for age, length of education, and county of residence. METHODS: Data from the SAMINOR 2 Questionnaire Survey was linked to records from the Norwegian Control and Payment of Health Refunds Database. Sami ethnicity was the primary exposure variable. Differences in mean number of consultations were investigated using the two-sample t-test. Adjustments for age (18-69 years), county of residence (Nordland/Trøndelag, Troms, Finnmark) and years of education (≤12 years, >12 years) were done using the generalized linear models Poisson loglinear and Negative binomial with log link. RESULTS: The study population consisted of 10,694 individuals: 5986 women (28.9% Sami) and 4708 men (22.7% Sami). Sami individuals had a significantly higher mean use of emergency medical care annually, and over the entire study period (2012-2019): Women (Sami 0.51, non-Sami 0.31, p < 0.01), Men (Sami 0.40, non-Sami 0.25, p < 0.01). However, no significant differences were observed in use of general practitioners. Adjusting for covariates did not alter the results for either outcome. CONCLUSION: The findings highlight ethnic disparities in primary healthcare utilization, showing higher use of emergency medical care in Sami compared to non-Sami. Further research should explore the underlying and probably multifaceted factors driving the observed differences.