Access to and utilisation of GP services among Burmese migrants in London: a cross-sectional descriptive study

Abstract

BackgroundAn estimated 10,000 Burmese migrants are currently living in London. No studies have been conducted on their access to health services. Furthermore, most studies on migrants in the United Kingdom (UK) have been conducted at the point of service provision, carrying the risk of selection bias. Our cross-sectional study explored access to and utilisation of General Practice (GP) services by Burmese migrants residing in London.MethodsWe used a mixed-method approach: a quantitative survey using self-administered questionnaires was complemented by qualitative in-depth interviews for developing the questionnaire and triangulating the findings of the survey. Overall, 137 questionnaires were received (a response rate of 57%) and 11 in-depth interviews conducted. The main outcome variables of the study included GP registration, barriers towards registration, GP consultations, barriers towards consultations, and knowledge on entitlements to health care. Quantitative data were analysed using descriptive statistics, association tests, and a multivariate analysis using logistic regression. The qualitative information was analysed using content analysis.ResultsThe respondents were young, of roughly equal gender (51.5% female), well educated, and had a fair level of knowledge on health services in the UK. Although the GP registration rate was relatively high (80%, 109 out of 136), GP service utilisation during the last episode of illness, at 56.8% (54 out of 95), was low. The statistical analysis showed that age being younger than 35 years, lacking prior overseas experience, having an unstable immigration status, having a shorter duration of stay, and resorting to self-medication were the main barriers hindering Burmese migrants from accessing primary health care services. These findings were corroborated by the in-depth interviews.ConclusionsOur study found that having formal access to primary health care was not sufficient to ensure GP registration and health care utilisation. Some respondents faced difficulties in registering with GP practices. Many of those who have registered prefer to forego GP services in favour of self-medication, partly due to long waiting times and language barriers. To ensure that migrants enjoy the health services they need and to which they are entitled, more proactive steps are required, including those that make health services culturally responsive.

National Health Service Principles as Experienced by Vulnerable London Migrants in "Austerity Britain": A Qualitative Study of Rights, Entitlements, and Civil-Society Advocacy

“…29,32,41,62 Results were consistent with studies by Mladovsky and others that migrants are confused about host country health systems and entitlements. 29,40,62 Several issues warrant improvement, including accessibility, communication, and clarity on migrant entitlements and GP responsibilities.…”

“…28 Access includes receipt of healthcare and consideration of the process and quality of care received. 29 It is affected by both intrinsic (eg, socio-cultural beliefs, 29 language, 13 literacy [30][31][32] ) and extrinsic factors (eg, service quality, service location 29,33 ). Equitable access requires information that is relevant, timely, and useful, and an enabling environment that treats service-users with respect and dignity.…”

Monitoring migrant health in Europe: A narrative review of data collection practices

“…Our search yielded three publications specifically concerned with monitoring migrant health in Europe [9][10][11], several research papers investigating the situation in selected EU countries [12][13][14][15][16], a number of outputs from recent EU-funded projects [17][18][19][20][21], several reports from international organizations related to migration and health [1][2][3][22][23][24][25], and a number of relevant documents from the EU and the Council of Europe [4][5][6][26][27][28][29].…”

The Intercultural Challenges of General Practitioners in Norway with Migrant Patients

“…Some years earlier, a study by Steen & Hunskår (2004) showed that 84% of patients could name their assigned GP. A high GP registration rate and a low rate of utilizing GP services have also been found (Aung et al, 2010).…”

“…Norwegian studies show that immigrants have a higher use of GPs than Norwegianborn individuals Aung et al, 2010); this provides a possible justification including unclear symptoms and poor communication leading to repeated visits. Also local EWs register higher utilization rates among migrants compared to Norwegian-born patients while Hargreaves et al (2006) showed in their study a lower utilization level among immigrants living in London.…”