European Journal of Public Health
Volume 28, Issue 3, 2018, Pages 445-451

Healthcare use among immigrants and natives in Sweden on disability pension, before and after changes of regulations (Article) (Open Access)

Di Thiene D.* , Rahman S. , Helgesson M. , Wang M. , Alexanderson K. , Tiihonen J. , La Torre G. , Mittendorfer-Rutz E.
  • a Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius Väg 3, Stockholm, SE-171 77, Sweden
  • b Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius Väg 3, Stockholm, SE-171 77, Sweden
  • c Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius Väg 3, Stockholm, SE-171 77, Sweden
  • d Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius Väg 3, Stockholm, SE-171 77, Sweden
  • e Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius Väg 3, Stockholm, SE-171 77, Sweden
  • f Department of Clinical Neuroscience, Center for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
  • g Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
  • h Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius Väg 3, Stockholm, SE-171 77, Sweden

Abstract

Background There is limited knowledge regarding psychiatric healthcare utilization around the time of granting disability pension (DP) due to common mental disorders (CMD) among immigrants and if this is related to social insurance regulations. The aim was to evaluate patterns of psychiatric healthcare utilization before and after DP due to CMD among immigrants and natives. A second aim was to evaluate if such patterns differed before and after changes in social insurance regulations in Sweden in 2008. Methods All 28 354 individuals living in Sweden with incident DP due to CMD, before (2005-06; n = 24 298) or after (2009-10; n = 4056) changes in regulations of granting DP, were included. Patterns of psychiatric in- and specialized outpatient healthcare utilization during a 7-year window around DP granting were assessed by Generalized Estimating Equations estimating multivariate adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Prevalence rates of psychiatric inpatient care were comparable among immigrants and natives, lower in non-Western immigrants (Africa, Asia and South-America). Three years after DP, non-Western immigrants in comparison to natives and Western immigrants had a stronger decrease in inpatient psychiatric healthcare: OR 0.48 (CI 0.38-0.62), 0.76 (0.70-0.83) and 1.01 (0.76-1.34), respectively. After 2008, a strong reduction in outpatient psychiatric healthcare after DP granting was observed, similarly in immigrants and natives. Conclusions Non-Western immigrants showed a different pattern of inpatient specialized healthcare after DP granting in comparison to natives. After changes in social insurance regulations, the decline in outpatient psychiatric healthcare following DP granting was comparable in immigrants and natives. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Author Keywords

[No Keywords available]

Index Keywords

pension Pensions mental health service Disabled Persons human middle aged disabled person statistics and numerical data Mental Health Services Mental Disorders mental disease Young Adult Sweden Humans migrant psychology male Emigrants and Immigrants female social security legislation and jurisprudence adult patient attitude Patient Acceptance of Health Care
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85048614715&doi=10.1093%2feurpub%2fckx206&partnerID=40&md5=db69ec21f44d60f11cd112370c7df005
DOI: 10.1093/eurpub/ckx206
ISSN: 11011262
Cited by: 1
Original Language: English