New Approaches to Immigrant Health Assessment

DesMeules, Marie; Gold, Jenny; Kazanjian, Arminée; Manuel, Doug; Payne, Jennifer; Vissandjée, Bilkis; McDermott, Sarah; Mao, Yang

doi:10.1007/bf03403661

Cited by 66 publications

(46 citation statements)

References 9 publications

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“…The complexity of what is actually happening is revealed in our data. Studies on health services utilization show that new immigrants are “underusers” of the health care system because of societal or cultural barriers, or because the existing services do not meet their needs [39]. This study revealed, however, that immigrants who were struggling to access health care services sometimes misused, overused, or failed to use the provided services.…”

Section: Discussionmentioning

confidence: 90%

A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

Dastjerdi

Olson

Ogilvie

2012

International Journal for Equity in Health

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BackgroundImmigration is not a new phenomenon but, rather, has deep roots in human history. Documents from every era detail individuals who left their homelands and struggled to reestablish their lives in other countries. The aim of this study was to explore and understand the experience of Iranian immigrants who accessed Canadian health care services. Research with immigrants is useful for learning about strategies that newcomers develop to access health care services.MethodsThe research question guiding this study was, “What are the processes by which Iranian immigrants learn to access health care services in Canada?” To answer the question, a constructivist grounded theory approach was applied. Initially, unstructured interviews were conducted with 17 participants (11 women and six men) who were adults (at least 18 years old) and had immigrated to Canada within the past 15 years. Eight participants took part in a second interview, and four participants took part in a third interview.ResultsUsing a constructivist grounded theory approach, “tackling the stumbling blocks of access” emerged as the core category. The basic social process (BSP), becoming self-sufficient, was a transitional process and had five stages: becoming a stranger; feeling helpless; navigating/seeking information; employing strategies; and becoming integrated and self-sufficient. We found that “tackling the stumbling blocks of access” was the main struggle throughout this journey. Some of the immigrants were able to overcome these challenges and became proficient in accessing health care services, but others were unable to make the necessary changes and thus stayed in earlier stages/phases of transition, and sometimes returned to their country of origin.ConclusionDuring the course of this journey a substantive grounded theory was developed that revealed the challenges and issues confronted by this particular group of immigrants. This process explains why some Iranian immigrants are able to access Canadian health care effectively while others cannot. Many elements, including language proficiency, cultural differences, education, previous experiences, financial status, age, knowledge of the host country’s health care services, and insider and outsider resources work synergistically in helping immigrants to access health care services effectively and appropriately.

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Section: Discussionmentioning

confidence: 90%

A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

Dastjerdi

Olson

Ogilvie

2012

International Journal for Equity in Health

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“…This contradicts the theory that associates lower socio-economic level with worse general health [30]. There are numerous studies pointing out that immigrants generally have a better level of health than host populations because the healthiest are more likely to migrate [31–37] (“healthy migration effect”) and this population group has better lifestyles [3, 23, 32]. …”

Section: Discussionmentioning

confidence: 99%

Differences in the Use of Primary Care Services Between Spanish National and Immigrant Patients

Gimeno-Feliu

Botaya

Macipe-Costa

et al. 2012

J Immigrant Minority Health

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Knowing what real use is made of health services by immigrant population is of great interest. The objectives are to analyze the use of primary care services by immigrants compared to Spanish nationals and to analyze these differences in relation to geographic origin. Retrospective observational study of all primary care visits made in 26 urban health centers. Main variable: total number of health centre visits/year. Dependent variables: type of clinician requested; type of attention, and origin of immigrants. The independent variable was nationality. Statistics were obtained from the electronic medical records. The 4,933,521 appointments made in 2007 were analyzed for a reference population of 594,145 people (11.15 % immigrants). The adjusted annual frequency for nationals was 8.3, versus whereas 4.6 for immigrants. The immigrant population makes less use of primary care services than national population. This is evident for all age groups and regardless of the immigrants’ countries of origin. This result is important when planning health care resources for immigrant population.

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“…These studies have been made on general populations and it is doubtful whether they can be applied to the paediatric population that has not undergone the selection process involved in emigrating to another country [5,7,39,42-47]. …”

Section: Discussionmentioning

confidence: 99%

Comparative study of paediatric prescription drug utilization between the spanish and immigrant population

Gimeno-Feliu

Armesto-Gómez

Macipe-Costa

et al. 2009

BMC Health Serv Res

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BackgroundThe immigrant population has increased greatly in Spain in recent years to the point where immigrants made up 12% of the infant population in 2008. There is little information available on the profile of this group with regard to prescription drug utilization in universal public health care systems such as that operating in Spain. This work studies the overall and specific differences in prescription drug utilization between the immigrant and Spanish population.MethodsUse was made of the Aragonese Health Service databases for 2006. The studied population comprises 159,908 children aged 0-14 years, 13.6% of whom are foreign nationals. Different utilization variables were calculated for each group. Prescription-drug consumption is measured in Defined Daily Doses (DDD) and DDD/1000 persons/day/(DID).ResultsA total of 833,223 prescriptions were studied. Utilization is lower for immigrant children than in Spanish children for both DID (66.27 v. 113.67) and average annual expense (€21.55 v. €41.14). Immigrant children consume fewer prescription drugs than Spanish children in all of the therapy groups, with the most prescribed (in DID) being: respiratory system, anti-infectives for systemic use, nervous system, sensory organs. Significant differences were observed in relation to the type of drugs and the geographical background of immigrants.ConclusionPrescription drug utilization is much greater in Spanish children than in immigrant children, particularly with reference to bronchodilators (montelukast and terbutaline) and attention-disorder hyperactivity drugs such as methylphenidate. There are important differences regarding drug type and depending on immigrants' geographical backgrounds that suggest there are social, cultural and access factors underlying these disparities.

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New Approaches to Immigrant Health Assessment

Cited by 66 publications

References 9 publications

A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

Differences in the Use of Primary Care Services Between Spanish National and Immigrant Patients

Comparative study of paediatric prescription drug utilization between the spanish and immigrant population

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