BMC Health Services Research
Volume 8, 2008

Hospital emergency department utilisation rates among the immigrant population in Barcelona, Spain (Article) (Open Access)

Buron A. , Cots F.* , Garcia O. , Vall O. , Castells X.
  • a Health Services Evaluation and Clinical Epidemiology Department, IMIM-Hospital del Mar, Barcelona, Spain, Educational Unit of Preventive Medicine and Public Health IMAS-UPF-ASPB, Barcelona, Spain, Departament de Pediatria, Obstetrícia I Ginecologia, I Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, Spain
  • b Health Services Evaluation and Clinical Epidemiology Department, IMIM-Hospital del Mar, Barcelona, Spain
  • c Neuropsychopharmacology Programme, Childhood and Environment Research Unit, IMIM-Hospital del Mar, Barcelona, Spain, Departament de Pediatria, Obstetrícia I Ginecologia, I Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, Spain
  • d Neuropsychopharmacology Programme, Childhood and Environment Research Unit, IMIM-Hospital del Mar, Barcelona, Spain, Departament de Pediatria, Obstetrícia I Ginecologia, I Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, Spain
  • e Health Services Evaluation and Clinical Epidemiology Department, IMIM-Hospital del Mar, Barcelona, Spain, Departament de Pediatria, Obstetrícia I Ginecologia, I Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, Spain

Abstract

Background. The recent increase in the number of immigrants of Barcelona represents a challenge for the public healthcare system, the emergency department being the most used healthcare service by this group. However, utilisation rates in our environment have not yet been studied. We aimed to compare emergency department utilisation rates between Spanish-born and foreign-born residents in a public hospital of Barcelona. Methods. The study population included all adults residing in the area of study and visiting the emergency department of Hospital del Mar in 2004. The emergency care episodes were selected from the Emergency Department register, and the population figures from the Statistics Department of Barcelona. Emergency care episodes were classified into five large clinical categories. Adjusted rate ratios (RR) of utilisation among foreign-born vs. Spanish-born residents were assessed through negative binomial regression. Results. The overall utilisation rate was 382 emergency contacts per 1,000 persons-years. The RR for foreign-born versus Spanish-born residents was 0.62 (95% CI: 0.52; 0.74%). The RR was also significantly below one in surgery (0.51, 95% CI: 0.42; 0.63), traumatology (0.47, 95% CI: 0.38; 0.59), medicine (0.48, 95% CI: 0.38; 0.59) and psychiatry (0.42, 95% CI: 0.18; 0.97). No differences were found in utilisation of gynaecology and minor emergency services. Conclusion. The overall lower utilisation rates obtained for foreign-born residents is consistent with previous studies and is probably due to the "healthy immigrant effect". Thus, the population increase due to immigration does not translate directly into a corresponding increase in the number of emergency contacts. The lack of differences in minor and gynaecological emergency care supports the hypothesis that immigrants overcome certain barriers by using the emergency department to access to health services. The issue of healthcare barriers should therefore be addressed, especially among immigrants. © 2008 Buron et al; licensee BioMed Central Ltd.

Author Keywords

[No Keywords available]

Index Keywords

immigrant hospitalization regression analysis binomial distribution diagnosis related group human Diagnosis-Related Groups middle aged statistics health service controlled study Aged emergency ward Humans Adolescent chi square distribution male Chi-Square Distribution Spain female population research Article health care utilization emergency care adult migration emergency health service Utilization Review Emergency Service, Hospital Emigration and Immigration Poisson distribution
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-42449109173&doi=10.1186%2f1472-6963-8-51&partnerID=40&md5=f3f1fb709ce8416c1b874d2bac2eacc0
DOI: 10.1186/1472-6963-8-51
ISSN: 14726963
Cited by: 57
Original Language: English