Length of stay,acculturation and transnational medical travel among Polish migrants in the Netherlands

An important aspect of the transnational lives of Polish migrants in the Netherlands is their frequent use of healthcare services in Poland. Transnational care use may be detrimental for the continuity and the quality of the care migrants receive. The current study aims to shed light on the antecedents of migrants' doctor visits in Poland. Drawing on a representative population-based sample of Polish migrants in the Netherlands (n = 1,082), logistic regression is used to assess whether length of stay in the Netherlands is negatively associated with the likelihood of doctor visits in Poland. The KHB decomposition method is used to determine the extent to which this potential association is mediated by three specific acculturation factors: ethnic identification, trust in the Dutch healthcare system and Dutch language proficiency. The models show that migrants who stayed in the Netherlands longer were less likely to visit doctors in Poland. Mediation analyses indicated that this effect was largely attributable to their greater Dutch language proficiency compared to their counterparts who arrived in the Netherlands more recently. Strong ethnic self-identification as Polish and lower trust in the Dutch healthcare system were also associated with a higher likelihood of visiting doctors in Poland. However, no significant mediation of the effect of length of stay via ethnic self-identification or Dutch language proficiency was found. The findings suggest that voluntary language programs may foster inclusion of Polish migrants in the Dutch healthcare system and reduce the need migrants perceive to seek care in their country of origin.