BMC Health Services Research
Volume 17, Issue 1, 2017

Medical condition and care of undocumented migrants in ambulatory clinics in Tel Aviv, Israel: Assessing unmet needs (Article) (Open Access)

Mor Z.* , Raveh Y. , Lurie I. , Leventhal A. , Gamzu R. , Davidovitch N. , Benari O. , Grotto I.
  • a Tel Aviv Department of Health Tel Aviv, 12 Ha'arba'a St, Tel Aviv, 6473912, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • b Faculty of Medicine, Hebrew University, Jerusalem, Israel
  • c Physician for Human Right (PHR-I), Tel Aviv, Israel, Kfar Saba Adult Clinic, Shalvata Mental Health Center, Hod Hasharon, Israel
  • d Faculty of Medicine, Hebrew University, Jerusalem, Israel
  • e Administration Department, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
  • f Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
  • g Lev El Lev Clinic, Ministry of Health, Tel Aviv, Israel
  • h Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel, Public Health Services, Ministry of Heath, Jerusalem, Israel

Abstract

Background: Approximately 150,000 undocumented migrants (UM) who are medically uninsured reside in Israel, including ~50,000 originating from the horn of Africa (MHA). Free medical-care is provided by two walk-in clinics in Tel-Aviv. This study aims to compare the medical complaints of UM from different origins, define their community health needs and assess gaps between medical needs and available services. Methods: This cross-sectional study included a random sample of 610 UM aged 18-64 years, who were treated in these community clinics between 2008 and 2011. The study compared UM who had complex medical conditions which necessitated referral to more equipped medical settings with UM having mild/simple medical conditions, who were treated at the clinics. Results: MHA were younger, unemployed and more commonly males compared with UM originating from other countries. MHA also had longer referral-delays and visited the clinics less frequently. UM with complex medical conditions were more commonly females, had chronic diseases and demonstrated longer referral-delays than those who had mild/simple medical conditions. The latter more commonly presented with complained of respiratory, muscular and skeletal discomfort. In multivariate analysis, the variables which predicted complex medical conditions included female gender, chronic illnes and self-referral to the clinics. Conclusions: The ambulatory clinics were capable of responding to mild/simple medical conditions. Yet, the health needs of women and migrants suffering from complex medical conditions and chronic diseases necessitated referrals to secondary/tertiary medical settings, while jeopardizing the continuity of care. The health gaps can be addressed by a more holistic social approach, which includes integration of UM in universal health insurance. © 2017 The Author(s).

Author Keywords

health inequalities Medical insurance Israel Health needs Immigration

Index Keywords

medically uninsured Israel human middle aged ethnology Cross-Sectional Studies Young Adult cross-sectional study Humans Adolescent male female patient referral Referral and Consultation Africa Ambulatory Care Facilities outpatient department adult migration sex factor Sex Factors Transients and Migrants Health Services Accessibility health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85023741645&doi=10.1186%2fs12913-017-2421-y&partnerID=40&md5=39722ff87e79df263e6d41f574f9407f
DOI: 10.1186/s12913-017-2421-y
ISSN: 14726963
Cited by: 4
Original Language: English