Primary Health Care Models Addressing Health Equity for Immigrants: A Systematic Scoping Review

Abstract

To examine two healthcare models, specifically "Primary Medical Care" (PMC) and "Primary Health Care" (PHC) in the context of immigrant populations' health needs. We conducted a systematic scoping review of studies that examined primary care provided to immigrants. We categorized studies into two models, PMC and PHC. We used subjects of access barriers and preventive interventions to analyze the potential of PMC/PHC to address healthcare inequities. From 1385 articles, 39 relevant studies were identified. In the context of immigrant populations, the PMC model was found to be more oriented to implement strategies that improve quality of care of the acute and chronically ill, while PHC models focused more on health promotion and strategies to address cultural and access barriers to care, and preventive strategies to address social determinants of health. Primary Health Care models may be better equipped to address social determinants of health, and thus have more potential to reduce immigrant populations' health inequities.

Providing care to refugees through mainstream general practice in the southern health region of New Zealand: a qualitative study of primary healthcare professionals’ perspectives

“…This aligns with recent discussions on the private ownership model of NZ general practice and its mixed fee for service/capitation funding model which contributes to access barriers to general practice services for vulnerable groups, including Māori, Pacific and those living in socioeconomically deprived areas 56 57. A systematic scoping review by Batista et al 58 suggests that comprehensive models of PHC underpinned by teamwork and interdisciplinary collaboration and strong links with community-based services may be better equipped to address health needs across the social determinants of health and thus have more potential capabilities to reduce disparities for culturally diverse groups including refugees 58. The integration of specialised components with existing general practice models may also allow for multidisciplinary expertise to be more readily available to PHC teams who need enhanced support to provide high-quality care to refugees.…”

“…The integration of specialised components with existing general practice models may also allow for multidisciplinary expertise to be more readily available to PHC teams who need enhanced support to provide high-quality care to refugees. Previous research indicated that it can be challenging to encourage general practices to accept refugees because they do not feel equipped to deal with the often unique challenges that refugees may bring 58. Ensuring that general practices stay committed to welcoming refugees is critical but this requires investment of sufficient resources to allow PHC professionals to feel supported in providing high-quality services.…”

The Role of Access to a Regular Primary Care Physician in Mediating Immigration-Based Disparities in Colorectal Screening: Application of Multiple Mediation Methods

“…Differences in effect sizes between white and visible minority recent immigrants may be explained by differences in ethno-cultural feelings of fatalism and helplessness with regards to colorectal cancer diagnosis and mortality (8) or in the acceptability of screening tests (15). On a more distal level, systemic discrimination (38), barriers to health care, and social stressors such as inadequate housing and precarious employment (39) are thought to explain, in part, why persons who immigrate to Canada -who, upon arrival are disproportionately healthy-see their health experience a decline in health over time, eventually converging with Canadian-born residents their age (11). These distal factors may also explain why such strong associations are observed between immigration experience and screening.…”

“…Beyond these determinants, one factor that is hypothesized to drive immigration-based inequalities in colorectal screening is the difficulty that many recent immigrants face in accessing primary health care services. In Canada, though immigrants granted permanent residency are entitled to universal health care coverage, linguistic, cultural and system-based barriers can make accessing health resources difficult (11,12). For example, recent immigrants are less likely than non-immigrants to have a primary care physician (PCP; ref.…”

Assessing Canadians Health Activity and Nutritional Habits Through Social Media

“…Removing all unnecessary text or data will limit the size of the feature matrix and speed up the training and classification task as some features are directly propositional to the speed of model training. As the number of features increases the speed of training the model also increases as given in Batista et al (19). Here, hashtags are not removed because it gives valuable information.…”