European Journal of Public Health
Volume 27, Issue 3, 2017, Pages 459-464

Access to healthcare for undocumented migrants: Analysis of avoidable hospital admissions in Sicily from 2003 to 2013 (Article) (Open Access)

Mipatrini D.* , Addario S.P. , Bertollini R. , Palermo M. , Mannocci A. , La Torre G. , Langley K. , Dembech M. , Barragan Montes S. , Severoni S.
  • a Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Roma, 00185, Italy
  • b Sicilian Epidemiological Observatory (DASOE), Palermo, Italy
  • c Chief Scientist and WHO Representative to the EU, World Health Organization Office at the European Union, Brussels, Belgium
  • d Sicilian Epidemiological Observatory (DASOE), Palermo, Italy
  • e Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Roma, 00185, Italy
  • f Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Roma, 00185, Italy
  • g Newcastle University Medical School, Newcastle-upon-Tyne, United Kingdom
  • h WHO Regional Office for Europe, Denmark
  • i Public Health and Migration, Division of Policy and Governance for Health and Well-being, WHO Regional Office for Europe, Copenhagen, Denmark
  • j Public Health and Migration, Division of Policy and Governance for Health and Well-being, WHO Regional Office for Europe, Copenhagen, Denmark

Abstract

Background: Access to healthcare services for undocumented migrants is one of the main public health issues currently being debated among European countries. Exclusion from primary healthcare services may lead to serious consequences for migrants' health. We analyzed the risk among undocumented migrants, in comparison with regular migrants, of being hospitalized for preventable conditions in the Region of Sicily (Italy). Methods: We performed a hospital-based cross-sectional study of the foreign population hospitalized in the Sicily region between 1 January 2003 and 31 December 2013. The first outcome was the proportion of avoidable hospitalization (AHs) among regular and irregular migrants. Second outcomes were the subcategories of AHs for chronic, acute and vaccine preventable diseases. Results: 85 309 hospital admissions were analyzed. In the hospitalized population, in comparison to regular migrants, undocumented migrants show a higher proportion of hospitalization for diseases preventable through primary and preventive care (AOR1·48, 95%CI 1·37-1·59). The proportion of avoidable hospitalizations associated with the lack of legal status is higher for vaccine preventable conditions (AOR 2·06, 95%CI 1·66-2·56) than for chronic conditions (AOR 1·47, 95%CI 1·42-1·63) and acute conditions (AOR 1·37; 95%CI 1·23-1·53). Between 2003 and 2013, the proportion of avoidable hospitalizations decreased both in regular and undocumented migrants but decreased faster for regular than for undocumented migrants. Conclusions: Undocumented migrants experience higher proportion of hospitalization for preventable conditions in comparison with regular migrants probably due to a lack of access to the national healthcare service. Policies and strategies to involve them in primary healthcare and preventive services should be developed to tackle this inequality. © 2017 The Author.

Author Keywords

[No Keywords available]

Index Keywords

statistics and numerical data male female Humans hospitalization Health Services Accessibility adult Transients and Migrants cross-sectional study Sicily Cross-Sectional Studies middle aged Young Adult human epidemiology migration health care delivery Adolescent
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85026726511&doi=10.1093%2feurpub%2fckx039&partnerID=40&md5=0d3827014ccee6d138fe62db1f2fb9fd
DOI: 10.1093/eurpub/ckx039
ISSN: 11011262
Cited by: 4
Original Language: English