Analysis of general practice consultation rates among Asian patients.

Sir, A recent survey of general practitioners has shown that more than 50% felt that Asian patients consulted more frequently and had longer consultations than non-Asian patients.' They also commented that Asian patients were more likely to present with trivial ailments. It is difficult to measure objectively the degree of frustration felt by general practitioners when confronted with a non-English-speaking Asian patient. What would be simpler and ultimately more informative would be to compare consultation rates of Asians with those of non-Asian patients. A previous study comparing consultation rates of Asian and non-Asian patients showed that the consultation rate of the Asians was more than twice that of the English patients.2 However, in that study, the total number of patients involved and the statistical data were unavailable. We have carried out a retrospective analysis of the consultation rates of Asian and non-Asian patients at a general practice in Hemel Hempstead. A total of 217 Asian patients were obtained from the Asian patient register and to avoid errors, these patients were double-checked on the computer which kept an age-sex-address register. The subjects were divided into five age groups, comparable with those used in previous studies of consultation rates.3 A non-Asian control was selected for each Asian patient at random from the age-sex-address register, matching for age, sex and address as closely as possible. The total number of consultations for the year 1990 was determined by counting all dated entries in the notes for that year except entries made by the practice nurse and entries for repeat prescriptions. The paired t-test (Student's test) was used to compare the paired observations. The number of consultations made by the Asian and non-Asian patients in 1990 is shown in Table 1. There was no significant difference in the number of consultations made by Asian and non-Asian patients for any age group. It is possible that the perception that Asian patients consult more frequently than non-Asians is linked to language and cultural barriers. Indeed, language problems may prevent the symptoms of Asian patients from being adequately explained thus giving rise to the false impression of presenting with trivial ailments. Another contributing factor may be that Asians frequently present out of hours, hence appearing to represent a Table 1. Number of consultations made by the Asian and non-Asian patients in 1990.