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Health care usage among immigrants and native-born elderly populations in eleven European countries: results from SHARE


Differences in health care utilization of immigrants 50 years of age and older relative to the native-born populations in eleven European countries are investigated. Negative binomial and zero-inflated Poisson regression are used to examine differences between immigrants and native-borns in number of doctor visits, visits to general practitioners, and hospital stays using the 2004 Survey of Health, Ageing, and Retirement in Europe database. In the pooled European sample and in some individual countries, older immigrants use from 13 to 20% more health services than native-borns after demographic characteristics are controlled. After controlling for the need for health care, differences between immigrants and native-borns in the use of physicians, but not hospitals, are reduced by about half. These are not changed much with the incorporation of indicators of socioeconomic status and extra insurance coverage. Higher country-level relative expenditures on health, paying physicians a fee-for-service, and physician density are associated with higher usage of physician services among immigrants.

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    We refer to the number of visits to the doctor but we mean the expected number given the explanatory characteristics.


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Part of this work was carried out while Aïda Solé-Auró was visiting the USC/UCLA Center of Biodemography and Population Health (Los Angeles, California, USA) supported by U.S. National Institutes of Health grant P30 AG17265. We also acknowledge financial support from the Spanish Ministry of Education and Science, FEDER grant SEJ2007-63298, ECO2010-21787. Earlier version of this paper was presented at the 2nd SHARE User Conference in Mainz, October 12–13, 2009. The authors gratefully acknowledge the comments received. This paper uses data from the early release of SHARE 2004. SHARE data collection was primarily funded through the European Commission through the 5th framework program (Project QLK6-CT-2001-0060 in the thematic program “Quality of Life”). Additional funding came from the US National Institute on Aging (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12816, Y1-AG-4553-01 and OGHA 04-064). Data collection in Austria, Belgium, and Switzerland was nationally funded.

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Correspondence to Aïda Solé-Auró.

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Solé-Auró, A., Guillén, M. & Crimmins, E.M. Health care usage among immigrants and native-born elderly populations in eleven European countries: results from SHARE. Eur J Health Econ 13, 741–754 (2012).

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  • Count data
  • Physician services
  • Elderly
  • Immigration