Health care utilisation and immigration in Spain

Antón, José María Monsalvo; Bustillo, Rafael Muñoz de

doi:10.1007/s10198-009-0204-z

Cited by 45 publications

(46 citation statements)

References 42 publications

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“…La población procedente de Europa del Este presentó mayor utilización que la autóctona a nivel nacional 29 , aunque un estudio describió menor utilización en hombres 32 y en Cataluña se observó mayor uso por parte de las mujeres, sin diferencias en hombres 35 Los diferentes estudios que analizaron el ingreso hospitalario no fueron concluyentes. Por un lado, un estudio basado en la ENS 31 no encontró diferencias entre inmigrantes de PRB y autóctonos. Aunque por otro lado, estudios basados en la ENS 29,39 y la ESCA 38 mostraron mayor nivel de hospitalizaciones de la población inmigrante en su conjunto 29 y de los menores de 15 años 38 , aun cuando se compararon con los autócto-nos incluyendo los inmigrantes de PRA 39 .…”

Section: Resultsunclassified

Acceso a los servicios de salud de la población inmigrante en España

Llop-Gironés

Lorenzo

García-Subirats

et al. 2014

Rev. Esp. Salud Publica

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RESUMENFundamentos: Una importante proporción de población en España es inmigrante y la evidencia internacional señala su acceso inadecuado a los servicios de salud. El objetivo es conocer el acceso a la atención de la población inmigrante en España.Métodos: Revisión bibliográfica de los artículos originales (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012) sobre acceso y utilización de los servicios de la población inmigrante en España registrados en Medline y MEDES. Se identificaron 319 artículos de los que se seleccionaron 20. Se utilizó el modelo de Aday y Andersen para el análisis. Resultados:Entre los artículos seleccionados, 13 estudios cuantitativos analizaron diferencias en la utilización de los servicios entre inmigrantes y autóctonos y 7 determinantes del acceso en inmigrantes. En lí-neas generales estos muestran menor utilización de la atención especializada, mayor de las urgencias y no se observaron diferencias entre grupos en atención primaria. Los 5 estudios cuantitativos sobre determinantes se centraron en las características de la población (sexo, edad, nivel de estudios y posesión de seguro privado) sin observarse un patrón claro. Los 2 estudios cualitativos analizaron factores relacionados con los servicios de salud y encontraron barreras en el acceso, como la provisión de información o los requisitos para obtener la tarjeta sanitaria. Conclusiones:El acceso a la atención en inmigrantes ha sido limitadamente abordado, con aproximaciones diferentes y los factores relacionados con la oferta, escasamente analizados. No se observa un patrón de utilización, las diferencias dependen de la clasificación de los inmigrante según origen y nivel asistencial. No obstante, en inmigrantes se observa menor utilización de la atención especializada y mayor de las urgencias, así como determinantes del acceso distintos a la necesidad. Background: An important proportion of the population in Spain is immigrant and the international literature indicates their inadequate access to health services. The objective is to contribute to improving the knowledge on access to health care of the immigrant population in Spain.

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Section: Resultsunclassified

Acceso a los servicios de salud de la población inmigrante en España

Llop-Gironés

Lorenzo

García-Subirats

et al. 2014

Rev. Esp. Salud Publica

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“…In Spain, greater use of hospital emergency services by immigrants has been reported by several authors [40,41], although others have ruled out this hypothesis [42]. The use of specialist care has been shown to be lower among immigrants [43], and similar trends have been highlighted concerning the level of double (public-private) coverage [44]. Our results indicate that there seems to be a shift from demanded visits (during PC visiting hours) towards PC emergency visits among the adult immigrant population.…”

Section: Discussionmentioning

confidence: 99%

Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

et al. 2011

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BackgroundThere is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden.MethodsThis retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System®).ResultsThe age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix.ConclusionsAlthough immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain.

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“…2, 3 The growth of Latino populations, defined as first and second generation self-identified Latinos in both countries, poses challenges for public health systems, from accessibility of behavioral health services 4, 5 to low quality and lack of continuity of care. 6 While disparities in behavioral health care among Latinos have been identified for Latinos in the U.S. 7, 8 , there is a paucity of research in both countries that identifies the barriers related to retention in care for Latinos and whether these barriers vary depending on the host country.…”

Section: Introductionmentioning

confidence: 99%

Barriers to and Correlates of Retention in Behavioral Health Treatment Among Latinos in 2 Different Host Countries: The United States and Spain

Falgas

Ramos

Herrera

et al. 2017

Journal of Public Health Management and Practice

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Context Latino immigrants constitute a large portion of the Spanish and U.S. immigrant populations, yet a dearth of research exists regarding barriers to retention in behavioral health care. Objectives To identify and compare perceived barriers related to behavioral health care among first and second generation Latinos in Boston, Madrid, and Barcelona, and evaluate whether the frequency of behavioral health care use in the last year was related to these barriers. Design, Setting and Participants Data come from the International Latino Research Partnership project. First or second generation self-identified Latino immigrants ages 18+ who resided more than one year in the host country were recruited from community agencies and primary care, mental health, substance abuse, and HIV clinics. Main Outcome Measures Eleven barriers were assessed and compared across sites. The relationship between barriers and behavioral services visits within the last year was evaluated, adjusting for socio-demographics, clinical measures, degree of health literacy, cultural and social factors. Results Wanting to handle the problem on one's own, thinking that treatment would not work, and being unsure of where to go or who to see were the most frequently reported barriers for Latino immigrants. Previous treatment failure, difficulties in transportation or scheduling, and linguistic barriers were more likely to be reported in Boston; trying to deal with mental health problems on one's own was more commonly reported in Barcelona and Madrid. Two barriers associated with number of visits were concerns about the cost of services and uncertainty about where to go or who to see. Conclusions After adjusting for socio-demographics, clinical measures, degree of health literacy, cultural and social factors, barriers still differed significantly across sites. Efforts to improve behavioral health services must be tailored to immigrants' context, with attention to changing attitudes of self-reliance and outreach to improve access to and retention in care.

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Health care utilisation and immigration in Spain

Cited by 45 publications

References 42 publications

Acceso a los servicios de salud de la población inmigrante en España

Acceso a los servicios de salud de la población inmigrante en España

Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

Barriers to and Correlates of Retention in Behavioral Health Treatment Among Latinos in 2 Different Host Countries: The United States and Spain

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