BMC Public Health
Volume 11, 2011

Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System (Article) (Open Access)

Calderón-Larrañaga A.* , Gimeno-Feliu L.A. , MacIpe-Costa R. , Poblador-Plou B. , Bordonaba-Bosque D. , Prados-Torres A.
  • a Instituto Aragonés de Ciencias de la Salud (I+CS), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
  • b Instituto Aragonés de Ciencias de la Salud (I+CS), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain, San Pablo Primary Health Care Centre, Servicio Aragonés de Salud (SALUD), Zaragoza, Spain
  • c Instituto Aragonés de Ciencias de la Salud (I+CS), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain, Fuentes de Ebro Primary Health Care Centre, Servicio Aragonés de Salud (SALUD), Zaragoza, Spain
  • d Instituto Aragonés de Ciencias de la Salud (I+CS), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
  • e Instituto Aragonés de Ciencias de la Salud (I+CS), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
  • f Instituto Aragonés de Ciencias de la Salud (I+CS), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain

Abstract

Background: There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden. Methods. This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System). Results: The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix. Conclusions: Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain. © 2011 Calderón-Larrãaga et al; licensee BioMed Central Ltd.

Author Keywords

[No Keywords available]

Index Keywords

urban population National Health Programs human middle aged Aged Young Adult Humans Adolescent male Emigrants and Immigrants Spain preschool child female Infant Child, Preschool Article Retrospective Studies adult migration Utilization Review Poisson distribution retrospective study primary health care public health Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-79957893181&doi=10.1186%2f1471-2458-11-432&partnerID=40&md5=8bab7d356115099b7a9866f87c333d44
DOI: 10.1186/1471-2458-11-432
ISSN: 14712458
Cited by: 29
Original Language: English