Access to Healthcare for Migrant Patients in Europe: Healthcare Discrimination and Translation Services

Abstract

Background: Discrimination based on ethnicity and the lack of translation services in healthcare have been identified as main barriers to healthcare access. However, the actual experiences of migrant patients in Europe are rarely present in the literature. Objectives: The aim of this study was to assess healthcare discrimination as perceived by migrants themselves and the availability of translation services in the healthcare systems of Europe. Methods: A total of 1407 migrants in 10 European Union countries (consortium members of the Mig-HealthCare project) were surveyed concerning healthcare discrimination, access to healthcare services, and need of translation services using an interviewer-administered questionnaire. Migrants in three countries were excluded from the analysis, due to small sample size, and the new sample consisted of N = 1294 migrants. Descriptive statistics and multivariable regression analyses were conducted to investigate the risk factors on perceived healthcare discrimination for migrants and refugees in the EU. Results: Mean age was 32 (±11) years and 816 (63.26%) participants were males. The majority came from Syria, Afghanistan, Iraq, Nigeria, and Iran. Older migrants reported better treatment experience. Migrants in Italy (0.191; 95% CI [0.029, 0.352]) and Austria (0.167; 95% CI [0.012, 0.323]) scored higher in the Discrimination Scale to Medical Settings (DMS) compared with Spain. Additionally, migrants with better mental health scored lower in the DMS scale (0.994; 95% CI [0.993, 0.996]), while those with no legal permission in Greece tended to perceive more healthcare discrimination compared with migrants with some kind of permission (1.384; 95% CI [1.189, 1.611]), as opposed to Austria (0.763; 95% CI [0.632, 0.922]). Female migrants had higher odds of needing healthcare assistance but not being able to access them compared with males (1.613; 95% CI [1.183, 2.199]). Finally, migrants with chronic problems had the highest odds of needing and not having access to healthcare services compared with migrants who had other health problems (3.292; 95% CI [1.585, 6.837]). Conclusions: Development of culturally sensitive and linguistically diverse healthcare services should be one of the main aims of relevant health policies and strategies at the European level in order to respond to the unmet needs of the migrant population.

Drivers and prevalence of COVID-19 vaccine uptake among homeless and precariously housed people in France: a cross-sectional population-based study

“…Participants in our sample reported lacking awareness of such strategies or misjudged their rights, with many mistakenly believing they lacked entitlement. Notably, we found that those with medical cover, registered with a GP, or who had recourse to the healthcare system, were more likely to access vaccination, in line with prior work on COVID-19 [27, 29] and other conditions [28]. Misinformation due to rumours, and defiance towards authorities reinforce these barriers, and are well-known in PEH [22, 23, 24, 27, 28, 29, 30].…”

“…Notably, we found that those with medical cover, registered with a GP, or who had recourse to the healthcare system, were more likely to access vaccination, in line with prior work on COVID-19 [27, 29] and other conditions [28]. Misinformation due to rumours, and defiance towards authorities reinforce these barriers, and are well-known in PEH [22, 23, 24, 27, 28, 29, 30].…”

“…Our data also show the positive impact on vaccine uptake by support mechanisms and follow-up by medical professionals and/or by social organizations. Such factors are rarely reported in the literature [27, 28], although some data documents the effects of lack of support from health personnel or even their negative influence on vaccination [28, 29].…”

Is the healthcare provision in the Netherlands compliant with universal health coverage based on the right to health? A narrative literature review

“…Asylum seekers are excluded from the Health Insurance Act and receive care through a parallel health system, with a central financial reimbursement policy for healthcare providers who provide services for undocumented migrants. While this policy ensures the availability of healthcare services for this group, it does not necessarily equate to adequate utilization of these services [ 59 – 61 ]. For example, the translation services have been defunded in an effort for cost-containment and to stimulate integration.…”

Geographical Access to Child and Family Healthcare Services and Hospitals for Africa-Born Migrants and Refugees in NSW, Australia; A Spatial Study

“…These findings could be interpreted from a structural and organisational point of view to delivering healthcare, given the way in which they intersect with multiple factors, including individuals’ legal status, resettlement, length of stay, and stress accessing healthcare resources. Studies have found that remoteness of a settlement, perceived discrimination in terms of benefits and healthcare entitlements, accessing resources, including social and language supports, public transport and employment, might worsen healthcare provision for people from refugee backgrounds [ 18 , 46 , 47 ]. According to Ziersch and colleagues, discrimination has been attributed to adverse impacts on the mental health of people from refugee backgrounds in Australia [ 46 ].…”