PLoS ONE
Volume 13, Issue 2, 2018

Access to health insurance coverage among sub-Saharan African migrants living in France: Results of the ANRS-PARCOURS study (Article) (Open Access)

Vignier N.* , Du Loû A.D. , Pannetier J. , Ravalihasy A. , Gosselin A. , Lert F. , Lydié N. , Bouchaud O. , Spira R.D. , PARCOURS Study Group
  • a INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, France, Groupe hospitalier Sud Ile-de-France, Department of Infectious and Tropical Diseases, Melun, France
  • b Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Paris, France
  • c Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Paris, France
  • d Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Paris, France
  • e Sorbonne Paris Cités, IRD, CEPED, ERL INSERM 1244 SAGESUD, Paris, France
  • f INSERM, Centre for Research in Epidemiology and Population Health (CESP-U 1018), Villejuif, France
  • g Santé Publique France, French National Agency of Public Health, Saint-Maurice, France
  • h Paris 13 University, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Infectious and Tropical diseases, Laboratoire Educations et Pratiques de Santé (LEPS EA 3412), Bobigny, France
  • i INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, France
  • j [Affiliation not available]

Abstract

Background Migrants’ access to care depends on their health insurance coverage in the host country. We aimed to evaluate in France the dynamic and the determinants of health insurance coverage acquisition among sub-Saharan migrants. Methods In the PARCOURS life-event retrospective survey conducted in 2012–2013 in health-care facilities in the Paris region, data on health insurance coverage (HIC) each year since arrival in France has been collected among three groups of sub-Saharan migrants recruited in primary care centres (N = 763), centres for HIV care (N = 923) and for chronic hepatitis B care (N = 778). Year to year, the determinants of the acquisition and lapse of HIC were analysed with mixed-effects logistic regression models. Results In the year of arrival, 63.4% of women and 55.3% of men obtained HIC. But three years after arrival, still 14% of women and 19% of men had not obtained HIC. HIC acquisition was accelerated in case of HIV or hepatitis B infection, for migrants arrived after 2000, and for women in case of pregnancy and when they were studying. Conversely, it was slowed down in case of lack of a residency permit and lack of financial resources for men. In addition, women and men without residency permits were more likely to have lost HIC when they had one. Conclusion In France, the health insurance system aiming at protecting all, including undocumented migrants, leads to a prompt access to HIC for migrants from sub-Saharan Africa. Nevertheless, this access may be impaired by administrative and social insecurities. © 2018 Vignier et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

primary medical care Africa south of the Sahara Human immunodeficiency virus infection clinical trial France health insurance sex ratio human middle aged life event time factor Time Factors ethnology Insurance, Health financial management interview Young Adult Humans migrant Adolescent Interviews as Topic male female Multivariate Analysis pregnancy Article Retrospective Studies adult migration health care access chronic hepatitis B Transients and Migrants retrospective study health care facility Health Services Accessibility health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85042196631&doi=10.1371%2fjournal.pone.0192916&partnerID=40&md5=3d813e88fb29c43b2ae067efa9f3e0d0
DOI: 10.1371/journal.pone.0192916
ISSN: 19326203
Cited by: 2
Original Language: English