The European Journal of Health Economics

, Volume 12, Issue 1, pp 17–28 | Cite as

Inequalities in the use of health services between immigrants and the native population in Spain: what is driving the differences?

  • Dolores Jiménez-RubioEmail author
  • Cristina Hernández-Quevedo
Original Paper


In Spain, a growing body of literature has drawn attention to analysing the differences in health and health resource utilisation of immigrants relative to the autochthonous population. The results of these studies generally find substantial variations in health-related patterns between both population groups. In this study, we use the Oaxaca-Blinder decomposition technique to explore to what extent disparities in the probability of using medical care use can be attributed to differences in the determinants of use due to, e.g. a different demographic structure of the immigrant collective, rather than to a different effect of health care use determinants by nationality, holding all other factors equal. Our findings show that unexplained factors associated to immigrant status determine to a great extent disparities in the probability of using hospital, specialist and emergency services of immigrants relative to Spaniards, while individual characteristics, in particular self-reported health and chronic conditions, are much more important in explaining the differences in the probability of using general practitioner services between immigrants and Spaniards.


Inequalities Health care utilisation Immigrant population Spanish National Health Survey Oaxaca decomposition 



Authors are grateful to Bruno Casal, MªLuz González-Álvarez and participants at the XXIX Jornadas de la Salud, Málaga (Spain) for valuable comments on earlier versions of this work. Any remaining errors are the sole responsibility of the authors. Also, the authors would like to acknowledge financial support from Fundación Alternativas, Madrid (Spain).


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Dolores Jiménez-Rubio
    • 1
    Email author
  • Cristina Hernández-Quevedo
    • 2
  1. 1.Department of Applied Economics, Faculty of Economics and Business Sciences, Campus Universitario de CartujaUniversity of GranadaGranadaSpain
  2. 2.European Observatory on Health Systems and PoliciesLondon School of Economics and Political ScienceLondonUK

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