Health Policy
Volume 120, Issue 4, 2016, Pages 396-405

Was access to health care easy for immigrants in Spain? The perspectives of health personnel in Catalonia and Andalusia (Article)

Vázquez M.-L.* , Vargas I. , Jaramillo D.L. , Porthé V. , López-Fernández L.A. , Vargas H. , Bosch L. , Hernández S.S. , Azarola A.R.
  • a Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo, 21, Barcelona, 08022, Spain
  • b Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo, 21, Barcelona, 08022, Spain
  • c Escuela Andaluza de Salud Pública, Campus Universitario de Cartuja, Cuesta del Observatorio, 4, Granada, Spain
  • d Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo, 21, Barcelona, 08022, Spain
  • e Escuela Andaluza de Salud Pública, Campus Universitario de Cartuja, Cuesta del Observatorio, 4, Granada, Spain
  • f Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo, 21, Barcelona, 08022, Spain, Agència de Salut Pública de Barcelona, Plaça Lesseps, 1, Barcelona, 08023, Spain
  • g Serveis de Salut Integrats Baix Empordà, Carrer Hospital 17-19, Palamós, 17230, Spain
  • h Escuela Andaluza de Salud Pública, Campus Universitario de Cartuja, Cuesta del Observatorio, 4, Granada, Spain
  • i Escuela Andaluza de Salud Pública, Campus Universitario de Cartuja, Cuesta del Observatorio, 4, Granada, Spain

Abstract

Until April 2012, all Spanish citizens were entitled to health care and policies had been developed at national and regional level to remove potential barriers of access, however, evidence suggested problems of access for immigrants. In order to identify factors affecting immigrants' access to health care, we conducted a qualitative study based on individual interviews with healthcare managers (n = 27) and professionals (n = 65) in Catalonia and Andalusia, before the policy change that restricted access for some groups. A thematic analysis was carried out. Health professionals considered access to health care "easy" for immigrants and similar to access for autochthons in both regions. Clear barriers were identified to enter the health system (in obtaining the health card) and in using services, indicating a mismatch between the characteristics of services and those of immigrants. Results did not differ among regions, except for in Catalonia, where access to care was considered harder for users without a health card, due to the fees charged, and in general, because of the distance to primary health care in rural areas. In conclusion, despite the universal coverage granted by the Spanish healthcare system and developed health policies, a number of barriers in access emerged that would require implementing the existing policies. However, the measures taken in the context of the economic crisis are pointing in the opposite direction, towards maintaining or increasing barriers. © 2016 Elsevier Ireland Ltd.

Author Keywords

Health personnel Health services accessibility Access to healthcare immigrants

Index Keywords

Health Personnel communication barrier rural area Communication Barriers immigrant health care policy insurance health care personnel human rural population qualitative research manager health personnel attitude interview Attitude of Health Personnel Humans migrant psychology Emigrants and Immigrants Spain organization and management thematic analysis major clinical study Health Policy Delivery of Health Care Health Services Accessibility primary health care health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84968456919&doi=10.1016%2fj.healthpol.2016.01.011&partnerID=40&md5=5306ab128f2e190ab4fe846ade61633b
DOI: 10.1016/j.healthpol.2016.01.011
ISSN: 01688510
Cited by: 10
Original Language: English