Immigrant and native regular general practitioners in Norway. A comparative registry-based observational study

Background: More than 10% of the population and nearly 20% of all general practitioners (GPs) in Norway have an immigrant background. There are reasons to believe that immigrant GPs have different demographic characteristic and serve different populations than native GPs. Objectives: To describe the characteristics of the lists and population subscribed to immigrant GPs in Norway and compare them with those of Norwegian-born GPs. Methods: Immigrant GPs were defined as persons born abroad with both parents from abroad. Two national registers were linked with information about all inhabitants and GPs in Norway in 2008: the GPs Database, and the National Population Register. Logistic regression was used to study the influence of the GP's immigrant background on different characteristics. Results: Compared to native GPs, immigrant GPs are younger, more often women, and more frequently work alone and in rural areas. GPs with immigrant background have a higher proportion of immigrant patients (OR = 3.2; 95% CI: 2.7-3.8), not only from their own culture, but also from other cultures, and this proportion increases over time. Immigrant GPs have more difficulties recruiting patients compared to their native colleagues (OR = 0.3; 95% CI: 0.3-0.4 for having closed lists), but this difference seems to diminish over time. There are, however, substantial differences between immigrant GPs from different areas of the world. Conclusion: The characteristics of the populations assigned to GPs with or without immigrant background are different. This should be taken into account when studying differences between immigrant and native GPs.