International Journal of Environmental Research and Public Health
Volume 11, Issue 10, 2014, Pages 10182-10201

Changes in access to health services of the immigrant and native-born population in Spain in the context of economic crisis (Article) (Open Access)

Garcia-Subirats I.* , Vargas I. , Sanz-Barbero B. , Malmusi D. , Ronda E. , Ballesta M. , Vázquez M.L.
  • a Health Policy and Health Services Research Group, Health Policy Research Unit, Consorci de Salut i Social de Catalunya, Avenida Tibidabo, 21, Barcelona, 08022, Spain, Melchor Fernández Almagro, 3–5, Madrid, 28029, Spain
  • b Health Policy and Health Services Research Group, Health Policy Research Unit, Consorci de Salut i Social de Catalunya, Avenida Tibidabo, 21, Barcelona, 08022, Spain, Melchor Fernández Almagro, 3–5, Madrid, 28029, Spain
  • c National School of Public Health, Instituto de Salud Carlos III, Avda Monforte de Lemos 5, Pabellón 7, Madrid, 28029, Spain, CIBERESP, Melchor Fernández Almagro, 3–5, Madrid, 28029, Spain
  • d Melchor Fernández Almagro, 3–5, Madrid, 28029, Spain, Agència de Salut Pública de Barcelona (IIB-Sant Pau), Plaça Lesseps 1, Barcelona, 08023, Spain
  • e Melchor Fernández Almagro, 3–5, Madrid, 28029, Spain, Public Health Department, University of Alicante, Carretera de San Vicente del Raspeig, s/n, Alicante, 03690, Spain, Center for Research in Occupational Health (CISAL), Universitat Pompeu Fabra, Doctor Aiguader, 88, Barcelona, 08003, Spain
  • f Melchor Fernández Almagro, 3–5, Madrid, 28029, Spain, Department of Epidemiology, Consejería de Sanidad y Política Social de la Región de Murcia, Murcia Regional Heath Authority, Ronda Levante, 11, Murcia, 30008, Spain
  • g Health Policy and Health Services Research Group, Health Policy Research Unit, Consorci de Salut i Social de Catalunya, Avenida Tibidabo, 21, Barcelona, 08022, Spain, Melchor Fernández Almagro, 3–5, Madrid, 28029, Spain

Abstract

Aim: To analyze changes in access to health care and its determinants in the immigrant and native-born populations in Spain, before and during the economic crisis. Methods: Comparative analysis of two iterations of the Spanish National Health Survey (2006 and 2012). Outcome variables were: unmet need and use of different healthcare levels; explanatory variables: need, predisposing and enabling factors. Multivariate models were performed (1) to compare outcome variables in each group between years, (2) to compare outcome variables between both groups within each year, and (3) to determine the factors associated with health service use for each group and year.Results: unmet healthcare needs decreased in 2012 compared to 2006; the use of health services remained constant, with some changes worth highlighting, such as the decline in general practitioner visits among autochthons and a narrowed gap in specialist visits between the two populations. The factors associated with health service use in 2006 remained constant in 2012.Conclusion: Access to healthcare did not worsen, possibly due to the fact that, until 2012, the national health system may have cushioned the deterioration of social determinants as a consequence of the financial crisis. Further studies are necessary to evaluate the effects of health policy responses to the crisis after 2012. © 2014 by the authors; licensee MDPI, Basel, Switzerland.

Author Keywords

access to health care Economic crisis Spain Health care utilization Immigration

Index Keywords

general practice immigrant lowest income group health survey indigenous people health disparity Economic Recession human trends middle aged statistics and numerical data health service comparative study general practitioner Health Surveys ethnology Health Services Needs and Demand social status migrant cross-sectional study Humans Adolescent male Emigrants and Immigrants Spain female specialization financial crisis health services Article service provision health care utilization adult health care quality health care access medical specialist utilization middle income group outcome assessment Health Services Accessibility Health Policy health care need health care delivery immigrant population
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84908321172&doi=10.3390%2fijerph111010182&partnerID=40&md5=c4845dfc2ab75d7ced4b2ec75f4f5de5
DOI: 10.3390/ijerph111010182
ISSN: 16617827
Cited by: 18
Original Language: English