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Different Patterns in Health Care Use Among Immigrants in Spain

Abstract

This study aims to analyze the differences in the use of primary care (PC), hospital, and emergency services between people born in Spain and immigrants. Data were obtained from the 2006 Spanish National Health Survey. The sample was composed of individuals aged 16–64 years from Spain and the seven countries with most immigrants in Spain (n = 22,224). Hierarchical multiple logistic regression models were fitted. Romanian men were less likely to use health care at all levels compared to men from other countries. Women from Argentina, Bolivia and Ecuador reported a lower use of PC. Among women, there were no differences in emergency visits or hospitalizations between countries. Bolivian men reported more hospitalizations than Spanish men, whereas Argentinean men reported more emergency visits than their Spanish counterparts. In Spain, most immigrants made less than, or about the same use of health care services as the native Spanish population.

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References

  1. 1.

    Carrasco-Garrido P, Jiménez-García R, Barrera V, de Andrés A, de Miguel A. Significant differences in the use of healthcare resources of native-born and foreign born in Spain. BMC Public Health. 2009;9:201.

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Jiménez-Rubio D, Hernández-Quevedo C. Inequalities in the use of health services between immigrants and the native population in Spain: What is driving the differences? Eur J Health Econ. 2011;12:17–28.

    Article  PubMed  Google Scholar 

  3. 3.

    Morris S, Sutton M, Gravelle H. Inequity and inequality in the use of health care in England: an empirical investigation. Soc Sci Med. 2005;60:1251–66.

    Article  PubMed  Google Scholar 

  4. 4.

    Norredam M, Nielsen S, Krasnik A, Moller Sorensen T, Keiding N, Joost Michaelsen J, et al. Emergency room utilization in Copenhagen: a comparison of immigrant groups and Danish-born residents. BMC Public Health. 2010;11:201.

    Google Scholar 

  5. 5.

    Norredam M, Nielsen SS, Krasnik A. Migrants’ utilization of somatic healthcare services in Europe-a systematic review. Eur J Public Health. 2010;20(5):555–63.

    Article  PubMed  Google Scholar 

  6. 6.

    Pavlic D, Brovc M, Svab I, Ahcin J, Slajpah M. Attitudes to illness and the use of health services by economic immigrants in Slovenia. Croat Med J. 2007;48:675–83.

    PubMed  Google Scholar 

  7. 7.

    Sanz B, Regidor E, Galindo S, Pascual C, Lostao L, Díaz J, et al. Pattern of health services use by immigrants from different regions of the world residing in Spain. Int J Public Health. 2011;56:567–76.

    Article  PubMed  Google Scholar 

  8. 8.

    Stronks K, Ravelli A, Reijneveld S. Immigrants in the Netherlands: equal access for equal needs? J Epidemiol Community Health. 2001;55:701–7.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Ben Cheikh W, Abad J, Arribas F, Andrés E, Rabanaque M. Utilización de los hospitales públicos por la población extranjera en Aragón (2004–2007). Gac Sanit. 2011;25:314–21.

    Article  PubMed  Google Scholar 

  10. 10.

    Dias S, Severo M, Barros H. Determinants of health care utilization by immigrants in Portugal. BMC Health Serv Res. 2008;8:207.

    Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Antón J, Muñoz De Bustillo R. Health care utilisation and immigration in Spain. Eur J Health Econ. 2010;11:487–98.

    Article  PubMed  Google Scholar 

  12. 12.

    Scheppers E, van Dongen E, Dekker J, Geertzen J, Dekker J. Potential barriers to the use of health services among ethnic minorities: a review. Fam Pract. 2006;23:325–48.

    Article  PubMed  Google Scholar 

  13. 13.

    Jiménez Rubio D. Equity in the use of health care services by immigrants in the spanish national health care system. Estudios Econ Apl. 2008;26:211–30.

    Google Scholar 

  14. 14.

    Lamkaddem M, Spreeuwenberg P, Devillé W, Foets M, Groenewegen P. Changes in health and primary health care use of Moroccan and Turkish migrants between 2001 and 2005: a longitudinal study. BMC Public Health. 2008;8:40.

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Bustamante AV, Fang H, Garza J, Carter-Pokras O, Wallace SP, Rizzo JA, et al. Variations in healthcare access and utilization among Mexican immigrants: the role of documentation status. J Immigr Minor Health. 2012;14(1):146–55.

    Article  Google Scholar 

  16. 16.

    Ingleby D. Ethnicity migration and the “social determinants of health” Etnicidad, Migración y la Agenda de los “Determinantes Sociales de la Salud”. Psychosoc Interv. 2012;21:331–41.

    Article  Google Scholar 

  17. 17.

    Lee S-Y, Arozullah A, Cho Y. Health literacy, social support, and health: a research agenda. Soc Sci Med. 2004;58:1309–21.

    Article  PubMed  Google Scholar 

  18. 18.

    Iwashyna TJ, Christakis NA. Marriage, widowhood, and health-care use. Soc Sci Med. 2003;57(11):2137–47.

    Article  PubMed  Google Scholar 

  19. 19.

    Addis M, Mahalik J. Men, masculinity, and the contexts of help seeking. Am Psychol. 2003;58:5–14.

    Article  PubMed  Google Scholar 

  20. 20.

    Galdas PM, Cheater F, Marshall P. Men and health help-seeking behaviour: literature review. J Adv Nurs. 2005;49:616–23.

    Article  PubMed  Google Scholar 

  21. 21.

    Artazcoz L, Borrell C, Cortès I, Escribà-Agüir V, Cascant L. Occupational epidemiology and work related inequalities in health: a gender perspective for two complementary approaches to work and health research. J Epidemiol Community Health. 2007;61(Suppl 2):39–45.

    Google Scholar 

  22. 22.

    Garcia-Subirats I, Vargas I. Changes in access to health services of the immigrant and native-born population in spain in the context of economic crisis. Int J Environ Res Public Health. 2014;11:10182–201.

    Article  PubMed  PubMed Central  Google Scholar 

  23. 23.

    Hernández-Quevedo C, Jiménez-Rubio D. A comparison of the health status and health care utilization patterns between foreigners and the national population in Spain: new evidence from the Spanish National Health Survey. Soc Sci Med. 2009;69:370–8.

    Article  PubMed  Google Scholar 

  24. 24.

    Legido-Quigley H, Otero L. Will austerity cuts dismantle the Spanish healthcare system ? BMJ. 2013;346:f2363.

    Article  PubMed  Google Scholar 

  25. 25.

    Vázquez ML, Vargas I, Aller M-B. The impact of the economic crisis on the health and healthcare of the immigrant population. SESPAS report 2014. Gac Sanit. 2014;28(Suppl 1):142–6.

    Article  PubMed  Google Scholar 

  26. 26.

    Hankivsky O, Cormier R. Intersectionality and public policy: some lessons from existing models. Polit Res Q. 2011;64:217–29.

    Article  Google Scholar 

  27. 27.

    Instituto Nacional de Estadística. Metodologia de La Encuesta Nacional de Salud de 2006. Madrid: Instituto Nacional de Estadística; 2007.

    Google Scholar 

  28. 28.

    Broadhead WE, Gehlbach SH, de Gruy FV, Kaplan BH. The Duke-UNC functional social support questionnaire: measurement of social support in family medicine patients. Med Care. 1988;26(7):709–23.

    CAS  Article  PubMed  Google Scholar 

  29. 29.

    Victora C, Huttly S, Fuchs S, Olinto M. The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol. 1997;26(1):224–7.

    CAS  Article  PubMed  Google Scholar 

  30. 30.

    López-Fernández LA, Martínez Millán JI, Fernández Ajuria A, March Cerdà JC, Suess A, Danet Danet A, et al. Is the universal coverage of our national health system in danger? Gac Sanit. 2012;26(4):298–300.

    Article  PubMed  Google Scholar 

  31. 31.

    Martinez O, Wu E, Sandfort T, Dodge B, Carballo-Dieguez A, Pinto R, et al. Evaluating the impact of immigration policies on health status among undocumented immigrants: a systematic review. J Immigr Minor Health. 2013.

  32. 32.

    Urbanos R, Puig-junoy J. Políticas de austeridad y cambios en las pautas de uso de los servicios sanitarios. Informe SESPAS. 2014;2014(28):81–8.

    Google Scholar 

  33. 33.

    Cordasco K, Ponce N, Gatchell M, Traudt B, Escarce J. English language proficiency and geographical proximity to a safety net clinic as a predictor of health care access. J Immigr Minor Health. 2011;13(2):260–7.

    Article  PubMed  PubMed Central  Google Scholar 

  34. 34.

    Brisset C, Leanza Y, Rosenberg E, Vissandjée B, Kirmayer L, Muckle G, et al. Language barriers in mental health care: a survey of primary care practitioners. J Immigr Minor Health. 2013;1–9.

  35. 35.

    Colectivo I, Fernández M, Fernández M. Encuesta Nacional de Inmigrantes 2007: el mercado de trabajo y las redes sociales de los inmigrantes [National Immigrant Survey 2007: the labor market and social networks of immigrants]. Madrid: Ministerio de Trabajo e Inmigración. Madrid. 2010.

  36. 36.

    Buron A, Cots F, Garcia O, Vall O, Castells X. Hospital emergency department utilisation rates among the immigrant population in Barcelona Spain. BMC Health Serv Res. 2008;8:51.

    Article  PubMed  PubMed Central  Google Scholar 

  37. 37.

    Calderón-Larrañaga A, Gimeno-Feliu LA, Macipe-Costa R, Poblador-Plou B, Bordonaba-Bosque D, Prados-Torres A. Primary care utilisation patterns among an urban immigrant population in the Spanish national health system. BMC Public Health. 2011;11(1):432.

    Article  PubMed  PubMed Central  Google Scholar 

  38. 38.

    Fernández M, Martín M, Galindo J, Vázquez J. Influencia en la salud de los factores culturales y sociales de los inmigrantes. El Médico Interactivo. 2004.

  39. 39.

    Alcalde-Rabanal JE, Lazo-González O, Nigenda G. Sistema de salud de Perú. Salud Publica Mex. Salud Pública de México. 2011;1 sSuppl 2:53.

  40. 40.

    Ledo C, Soria R. The health system of Bolivia. Salud pública Méx. 2011;53(suppl 2):s109–s119.

  41. 41.

    Villarroel N, Artazcoz L. Heterogeneous patterns of health status among immigrants in Spain. Health Place. 2012;18(6):1282–91.

    Article  PubMed  Google Scholar 

  42. 42.

    Montenegro RA, Stephens C. Indigenous health in Latin America and the Caribbean. Lancet. 2006;367(9525):1859–69.

    Article  PubMed  Google Scholar 

  43. 43.

    Möller-Leimkühler A. Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. J Affect Disord. 2002;71:1–9.

    Article  PubMed  Google Scholar 

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Correspondence to Lucía Artazcoz.

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Villarroel, N., Artazcoz, L. Different Patterns in Health Care Use Among Immigrants in Spain. J Immigrant Minority Health 18, 318–329 (2016). https://doi.org/10.1007/s10903-015-0202-4

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Keywords

  • Immigrants
  • Spain
  • Health care disparities
  • Socio-economic factors
  • Gender