Introduction. Immigration is constantly increasing in Italy. In spite of the last regularization, after the "Bossi-Fini" law (n. 189 30 July 2002) came into force, at the present illegal quota of immigrants is about 800,000 units. Many Public Health issues arise with this phenomenon. Above all, infectious diseases are serious problems. The evaluation of immigrants' health needs and health care demand, and the assessment of National Health Service (NHS) offer and its accessibility to them are essential for a correct Public Health approach. The aim of our study is the design of an organizational pathway to facilitate immigrants' access to NHS both for diagnosis services and vaccination interventions Methods. A feasibility assessment was carried out through structured interviews to the medical and administrative chiefs of involved different organizations. The serological survey (before vaccination interventions) was carried out by Elisa test for rubella (in women at fertile age), tetanus, diphtheria and hepatitis B and by neutralizing antibody titration for poliomyelitis. Descriptive and inferential statistics were carried out to evaluate the frequency distribution of the recorded variables. Differences among groups were tested at a p value significance level of 0.05 using Chi-square test for categorical variables and Student's t test for numerical variables. Results. An organizational pathway to facilitate the immigrants' access to NHS was planned and implemented. In the study period 229 immigrants accepted to participate; among them 99 immigrants reached the hospital to perform the diagnostic analysis, resulting in a compliance of 43.23%. No significant statistical differences were shown by gender. The average time between the prescription of the analysis and the arrival to the hospital was 4 days for females, and 11.8 days for males and the different was statistically significant at the Student's t test (p value < 0.05). Continent of origin, school attendance, and age, were also studied comparing the two groups (responders and non-responders). Migrants coming from Eastern Europe were the largest group, but they showed the lowest compliance. Discussion. The results of our study give an example of integrated health services for immigrates performed by the collaboration between private and public providers with the aim of facilitating the access of migrant people to the NHS. Conclusion. Notwithstanding our efforts, the results of this study confirm immigrant's difficulties to access to services as it is showed by the low compliance value (49.23%). Even if Italian laws protect and promote illegal immigrants' health rights, difficulties in the access rise up all the same, maybe because of the scarce knowledge of their rights, because of the different cultures and the insufficient confidence on preventive interventions.

Illegal immigrants Access to NHS Vaccination interventions

structured interview health service human enzyme linked immunosorbent assay rubella vaccination hepatitis B Student t test poliomyelitis chi square test diphtheria Article tetanus statistical significance health care organization immigration