Preventive Medicine
Volume 59, Issue 1, 2014, Pages 19-24

The lower quality of preventive care among forced migrants in a country with universal healthcare coverage (Article)

Martin Y. , Collet T.-H. , Bodenmann P. , Blum M.R. , Zimmerli L. , Gaspoz J.-M. , Battegay E. , Cornuz J. , Rodondi N.*
  • a Department for Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
  • b Department for Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland, Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Switzerland
  • c Department for Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
  • d Department of General Internal Medicine, Inselspital, University of Bern, Switzerland
  • e Division of Internal Medicine, University Hospital of Zürich, Zürich, Switzerland
  • f Department of Community Medicine and Primary Care, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
  • g Division of Internal Medicine, University Hospital of Zürich, Zürich, Switzerland
  • h Department for Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
  • i Department of General Internal Medicine, Inselspital, University of Bern, Switzerland

Abstract

Objective: To assess the association between socio-demographic factors and the quality of preventive care and chronic care of cardiovascular (CV) risk factors in a country with universal health care coverage. Methods: Our retrospective cohort assessed a random sample of 966 patients aged 50-80. years followed over 2. years (2005-2006) in 4 Swiss university primary care settings (Basel/Geneva/Lausanne/Zürich). We used RAND's Quality Assessment Tools indicators and examined recommended preventive care among different socio-demographic subgroups. Results: Overall patients received 69.6% of recommended preventive care. Preventive care indicators were more likely to be met among men (72.8% vs. 65.4%; p<. 0.001), younger patients (from 71.0% at 50-59. years to 66.7% at 70-80. years, p for trend. = 0.03) and Swiss patients (71.1% vs. 62.7% in forced migrants; p= 0.001). This latter difference remained in multivariate analysis adjusted for gender, age, civil status and occupation (OR 0.68; 95% CI 0.54-0.86). Forced migrants had lower scores for physical examination and breast and colon cancer screening (all p≤. 0.02). No major differences were seen for chronic care of CV risk factors. Conclusion: Despite universal healthcare coverage, forced migrants receive less preventive care than Swiss patients in university primary care settings. Greater attention should be paid to forced migrants for preventive care. © 2013 Elsevier Inc.

Author Keywords

Forced migrants Quality of care Socio-demographic characteristics Preventive care Vulnerable populations

Index Keywords

immigrant primary medical care cardiovascular risk multicenter study economics clinical trial insurance long term care Preventive Health Services health insurance human follow up middle aged statistics and numerical data social aspect priority journal Aged chronic disease ethnology screening human rights Humans male female Aged, 80 and over Socioeconomic Factors very elderly preventive health service Multivariate Analysis socioeconomics quality control standards scoring system Article legislation and jurisprudence Retrospective Studies major clinical study adult migration health care quality Quality of Health Care preventive medicine Transients and Migrants retrospective study colon cancer Physical Examination Quality Indicators, Health Care Universal Coverage Switzerland primary health care
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84892435465&doi=10.1016%2fj.ypmed.2013.11.006&partnerID=40&md5=a67972f73aa851c487acc838507f76a6
DOI: 10.1016/j.ypmed.2013.11.006
ISSN: 00917435
Cited by: 8
Original Language: English