BMC Public Health
Volume 16, Issue 1, 2016

Global healthcare use by immigrants in Spain according to morbidity burden, area of origin, and length of stay (Article) (Open Access)

Gimeno-Feliu L.A.* , Calderón-Larrañaga A. , Diaz E. , Poblador-Plou B. , Macipe-Costa R. , Prados-Torres A.
  • a EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain, San Pablo Health Centre, C/ Aguadores 7, Zaragoza, 50003, Spain, Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
  • b EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain
  • c Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway, Norwegian Centre for Minority Health Research (NAKMI), Oslo University Hospital, Bergen, Norway
  • d EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain
  • e San Pablo Health Centre, C/ Aguadores 7, Zaragoza, 50003, Spain
  • f EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain, Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain

Abstract

Background: The healthcare of immigrants is an important aspect of equity of care provision. Understanding how immigrants use the healthcare services based on their needs is crucial to establish effective health policy. Methods: This retrospective, observational study included the total population of Aragon, Spain (1,251,540 individuals, of whom 11.9 % were immigrants). Patient-level data on the use of primary, specialised, hospital, and emergency care as well as prescription drug use in 2011 were extracted from the EpiChron Cohort and compared between immigrants and nationals. Multivariable standard or zero-inflated negative binomial regression models were generated, adjusting for age, sex, length of stay, and morbidity burden. Results: The annual visit rates of immigrants were lower than those of nationals for primary care (3.3 vs 6.4), specialised care (1.3 vs 2.7), planned hospital admissions/100 individuals (1.6 vs 3.8), unplanned hospital admissions/100 individuals (2.7 vs 4.7), and emergency room visits/10 individuals (2.3 vs 2.8). Annual prescription drug costs were also lower for immigrants (€47 vs €318). These differences were only partially attenuated after adjusting for age, sex and morbidity burden. Conclusion: In a universal coverage health system offering broad legal access to immigrants, the global use of healthcare services was lower for immigrants than for nationals. These differences may be explained in part by the healthy migration effect, but also reveal possible inequalities in healthcare provision that warrant further investigation. © 2016 Gimeno-Feliu et al.

Author Keywords

[No Keywords available]

Index Keywords

human middle aged Asia statistics and numerical data Aged morbidity length of stay ethnology Cross-Sectional Studies Young Adult cross-sectional study migrant Humans Adolescent Infant, Newborn male Emigrants and Immigrants female preschool child Infant Child, Preschool newborn Spain Africa Retrospective Studies adult utilization patient attitude Patient Acceptance of Health Care retrospective study Healthcare Disparities health care disparity primary health care Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84971441906&doi=10.1186%2fs12889-016-3127-5&partnerID=40&md5=c07ea46690d3e0ca9f8e740f3d73201e
DOI: 10.1186/s12889-016-3127-5
ISSN: 14712458
Cited by: 11
Original Language: English