PLoS ONE
Volume 13, Issue 7, 2018

Health of undocumented migrants in primary care in Switzerland (Article) (Open Access)

Jackson Y.* , Paignon A. , Wolff H. , Delicado N.
  • a Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland, Global Health Institute, University of Geneva, Geneva, Switzerland
  • b HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Geneva, Switzerland
  • c Division of Prison Health, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland
  • d HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Geneva, Switzerland

Abstract

Background Undocumented migrants endure adverse living conditions while facing barriers to access healthcare. Evidence is lacking regarding their healthcare needs, notably in regards to chronic diseases. Our goal was to investigate health conditions in undocumented migrants attended in primary care setting. Methods This study was conducted at the primary care outpatient clinic, Geneva University Hospitals, Switzerland. We retrospectively recorded and coded all medical conditions of a random sample of 731 undocumented migrants using the International Classification of Primary Care, 2nd version (ICPC-2). We dichotomized conditions as chronic or non-chronic and considered multimorbidity in the presence of three or more chronic conditions. Results Participants originated from 72 countries and were mainly female (65.5%) with a mean age of 42.4 (standard deviation [SD]: 11.4) years. They presented a mean of 2.9 (SD: 2.1; range: 1–17) health conditions. In multivariable analysis, the number of conditions was associated with female gender (p = 0.011) and older age (p <0.001), but not with origin (p = 0.373). The body systems most frequently affected were endocrine, metabolic and nutritional (n = 386; 18.4%), musculoskeletal (n = 308, 14.7%) and digestive (n = 266, 12.8%). Hypertension (17.9%; 95% CI: 15.2%, 29.9%), obesity or overweight (16%; 95% CI: 13.4%, 18.9%) and gastric problems (14.1%; 95% CI: 11.6%, 16.8%) were most prevalent. Overall, 71.8% (95% CI: 68.5%, 75%) participants had at least one chronic condition while 20% (95% CI: 17.2%, 23.1%) had three or more. In multivariable analysis, age (p <0.001) was the only predictor of presenting at least one or three or more chronic conditions. © 2018 Jackson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

primary medical care long term care university hospital human middle aged gastrointestinal disease metabolic disorder endocrine disease obesity nutritional disorder health status hypertension Aged stomach disease multiple chronic conditions chronic disease musculoskeletal disease Undocumented Immigrants Young Adult Humans undocumented immigrant Adolescent male female prediction outpatient department prevalence Article major clinical study adult gender health care access sex factor Sex Factors age retrospective study Delivery of Health Care disease burden Switzerland health care delivery

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85051710344&doi=10.1371%2fjournal.pone.0201313&partnerID=40&md5=ffb2076d1d0d978f05df7b2f9a65ae97

DOI: 10.1371/journal.pone.0201313
ISSN: 19326203
Cited by: 4
Original Language: English