Scandinavian Journal of Public Health
Volume 40, Issue 3, 2012, Pages 260-270

Is there equity in use of healthcare services among immigrants, their descendents, and ethnic Danes? (Article)

Nielsen S.S.* , Waldorff F.B. , Kreiner S. , Krasnik A. , Hempler N.F.
  • a Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • b Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • c Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • d Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • e Steno Diabetes Center, Steno Health Promotion Center, Gentofte, Denmark

Abstract

Background: Legislation in Denmark explicitly states the right to equal access to healthcare. Nevertheless, inequities may exist; accordingly evidence is needed. Our objective was to investigate whether differences in healthcare utilisation in immigrants, their descendents, and ethnic Danes could be explained by health status, socioeconomic factors, and integration. Methods: We conducted a nationwide survey in 2007 with 4952 individuals aged 18–66 comprising ethnic Danes; immigrants from the former Yugoslavia, Iran, Iraq, Lebanon, Pakistan, Somalia, Turkey; and Turkish and Pakistani descendents. Data were linked to registries on healthcare utilisation. Using Poisson regression models, contacts to hospital, emergency room (ER), general practitioner (GP), specialist in private practice, and dentist were estimated. Analyses were adjusted for health symptoms, sociodemographic factors, and proxies of integration. Results: In adjusted analyses, immigrants and their descendents had increased use of ER (multiplicative effect 1.19–5.02 dependent on immigrant and descendent group) and less frequent contact to dentist (multiplicative effect 0.04–0.80 dependent on the group). For hospitalisation, GP, and specialist doctor, physical health symptoms had positive but different explanatory effects within groups; however, most immigrant and descendent groups had increased use of services compared with that of ethnic Danes. Socioeconomic factors and integration had no systematic effect on the use in the different groups. Conclusions: The Danish healthcare system seems responsive to health across different population groups. We found no systematic pattern of inequity in use of free-of-charge healthcare services, but for dentists, who require co-payment, we found inequity among immigrants and descendents compared with ethnic Danes. © 2012, the Nordic Societies of Public Health. All rights reserved.

Author Keywords

Hospitalisation dentist Utilisation General practitioner Health status Migrants Denmark emergency room Access Inequality

Index Keywords

regression analysis human middle aged Denmark Ethnic Groups health service ethnic group health status Aged ethnology Young Adult Humans Adolescent male Emigrants and Immigrants female Socioeconomic Factors socioeconomics health services Article adult migration Utilization Review

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84861816830&doi=10.1177%2f1403494812443602&partnerID=40&md5=d838685d3bf29dfe3af1cd985d52d60f

DOI: 10.1177/1403494812443602
ISSN: 14034948
Cited by: 34
Original Language: English