Abstract
Objectives
The aim of this study was to analyze the characteristics of accident and emergency department (A and E) access, process management and outcome after grouping patients by their citizenship.
Methods
The study was conducted using the recorded linkage database at a local public health agency in north-east Italy. We investigated 35,541 adult patients (18–65 years) accessing the A and E.
Results
An underutilization of primary care services and the use of A and E for nonurgent conditions is a problem affecting all nationalities, natives included. The length of the stay in A and E and the consistency between level of urgency and priority of the visits at entry and exit triage were similar for all citizenship groups. Illegal migrants were more frequently hospitalized after A and E visits than other groups.
Conclusions
The potentially inappropriate use of A and E for non-urgent conditions was common among all the patient groups considered and barriers to primary care may enhance this behavior among migrants. This situation could also explain the higher odds ratio for migrants’ hospitalization and discharge to ambulatory services after A and E visits.
Similar content being viewed by others
References
Baglio G, Saunders C, Spinelli A et al (2010) Utilisation of hospital services in Italy: a comparative analysis of immigrant and Italian citizens. J Immigr Minor Health 12(4):598–609
Bonvicini L, Broccoli S, D’Angelo S et al (2011) Emergency room services utilization in the province of Reggio Emilia: a comparison between immigrants and Italians. Epidemiol Prev 35(5–6):259–266
Brigidi S, Cremonesi P, Cristina ML et al (2008) Inequalities and health: analysis of a model for the management of Latin American users of an emergency department. J Prev Med Hyg 49(1):6–12
Cacciani L, Baglio G, Rossi L et al (2006) Hospitalisation among immigrants in Italy. Emerg Themes Epidemiol 3:4
Carret ML, Fassa AG, Kawachi I (2007) Demand for emergency health service: factors associated with inappropriate use. BMC Health Serv Res 7:131
Cots F, Castells X, Garcia O et al (2007) Impact of immigration on the cost of emergency visits in Barcelona (Spain). BMC Health Serv Res 7:9
Gaddini A, Franco F, Biscaglia L, Di Lallo D (2008) An urban Italian study on emergency room utilisation by immigrants suffering from mental disorders in Rome. Eur Psychiatry 23(2):118-24. doi:10.1016/j.eurpsy.2007.11.007
Grassino EC, Guidi C, Monzani A, Di Pietro P, Bona G (2009) Access to paediatric emergency departments in Italy: a comparison between immigrant and Italian patients. Ital J Pediatr 35(1):3. doi:10.1186/1824-7288-35-3
Jimenez-Rubio D, Hernandez-Quevedo C (2011) Inequalities in the use of health services between immigrants and the native population in Spain: what is driving the differences? Eur J Health Econ 12(1):17–28
Kevin Watkins et al (2009) United Nations Development Program, Human Development Report 2007/2008
Nielsen SS, Krasnik A, Rosano A (2009) Registry data for cross-country comparisons of migrants’ healthcare utilization in the EU: a survey study of availability and content. BMC Health Serv Res 9:210
Norredam M, Krasnik A, Moller Sorensen T et al (2004) Emergency room utilization in Copenhagen: a comparison of immigrant groups and Danish-born residents. Scand J Public Health 32(1):53–59
Norredam M, Mygind A, Nielsen AS et al (2007) Motivation and relevance of emergency room visits among immigrants and patients of Danish origin. Eur J Public Health 17(5):497–502
Norredam M, Nielsen SS, Krasnik A (2010) Migrants’ utilization of somatic healthcare services in Europe—a systematic review. Eur J Public Health 20(5):555–563
Rue M, Cabre X, Soler-Gonzalez J et al (2008) Emergency hospital services utilization in Lleida (Spain): a cross-sectional study of immigrant and Spanish-born populations. BMC Health Serv Res 8:81
Sabbatani S, Baldi E, Manfredi R (2007) Time trends in health care needs of non-EU citizens from developing countries, admitted to a general hospital in northern Italy. Infez Med 15(4):242–249
Sonnenberg A (1988) Factors which influence the incidence and course of peptic ulcer. Scand J Gastroenterol Suppl 155:119–140
Testi A, Ivaldi E (2008) L'esercizio del diritto alla tutela della salute: accesso degli immigrati ai servizi sanitari in regione Liguria. In Immigrazione e diritti umani nel quadro legislativo attuale (a cura di Costanzo P, Mordeglia S, Trucco L, Giuffrè editore. Milano, Annali della Facoltà di Giurisprudenza di Genova, pp 115-132
Torres AM, Sanz B (2000) Healthcare provision for illegal immigrants: should public health be concerned? J Epidemiol Community Health 54:478–479
US Department of Health and Human Services (1997) International classification of diseases, 9th revision, clinical modifications (ICD-9-CM), sixth ed. US DHHS, Public Health Service, Health Care Financing Administration, Washington, DC, DHHS publication no (PHS) 96-1260
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Buja, A., Fusco, M., Furlan, P. et al. Characteristics, processes, management and outcome of accesses to accident and emergency departments by citizenship. Int J Public Health 59, 167–174 (2014). https://doi.org/10.1007/s00038-013-0483-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-013-0483-0