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伦敦缅甸移民获取和使用全科医生服务的情况:一项横断面描述性研究。

Access to and utilisation of GP services among Burmese migrants in London: a cross-sectional descriptive study.

机构信息

Epidemiology & Public Health Department, Swiss Tropical and Public Health Institute, 4002 Basel, Switzerland.

出版信息

BMC Health Serv Res. 2010 Oct 12;10:285. doi: 10.1186/1472-6963-10-285.

Abstract

BACKGROUND

An estimated 10,000 Burmese migrants are currently living in London. No studies have been conducted on their access to health services. Furthermore, most studies on migrants in the United Kingdom (UK) have been conducted at the point of service provision, carrying the risk of selection bias. Our cross-sectional study explored access to and utilisation of General Practice (GP) services by Burmese migrants residing in London.

METHODS

We used a mixed-method approach: a quantitative survey using self-administered questionnaires was complemented by qualitative in-depth interviews for developing the questionnaire and triangulating the findings of the survey. Overall, 137 questionnaires were received (a response rate of 57%) and 11 in-depth interviews conducted. The main outcome variables of the study included GP registration, barriers towards registration, GP consultations, barriers towards consultations, and knowledge on entitlements to health care. Quantitative data were analysed using descriptive statistics, association tests, and a multivariate analysis using logistic regression. The qualitative information was analysed using content analysis.

RESULTS

The respondents were young, of roughly equal gender (51.5% female), well educated, and had a fair level of knowledge on health services in the UK. Although the GP registration rate was relatively high (80%, 109 out of 136), GP service utilisation during the last episode of illness, at 56.8% (54 out of 95), was low. The statistical analysis showed that age being younger than 35 years, lacking prior overseas experience, having an unstable immigration status, having a shorter duration of stay, and resorting to self-medication were the main barriers hindering Burmese migrants from accessing primary health care services. These findings were corroborated by the in-depth interviews.

CONCLUSIONS

Our study found that having formal access to primary health care was not sufficient to ensure GP registration and health care utilisation. Some respondents faced difficulties in registering with GP practices. Many of those who have registered prefer to forego GP services in favour of self-medication, partly due to long waiting times and language barriers. To ensure that migrants enjoy the health services they need and to which they are entitled, more proactive steps are required, including those that make health services culturally responsive.

摘要

背景

目前约有 1 万名缅甸移民居住在伦敦。尚未对他们获得卫生服务的情况进行研究。此外,英国(UK)大多数关于移民的研究都是在服务提供点进行的,存在选择偏差的风险。我们的横断面研究探讨了居住在伦敦的缅甸移民获得和利用全科医生(GP)服务的情况。

方法

我们采用了混合方法:使用自我管理问卷的定量调查辅以定性深入访谈,以开发问卷并对调查结果进行三角测量。总共收到了 137 份问卷(响应率为 57%),并进行了 11 次深入访谈。研究的主要结局变量包括全科医生注册、注册障碍、全科医生咨询、咨询障碍以及对医疗保健权益的了解。使用描述性统计、关联测试和使用逻辑回归的多变量分析对定量数据进行分析。定性信息采用内容分析进行分析。

结果

受访者年龄较轻,性别大致相等(女性占 51.5%),教育程度较高,对英国卫生服务有一定的了解。尽管 GP 注册率相对较高(80%,136 人中的 109 人),但在上一次疾病发作期间,GP 服务利用率仅为 56.8%(95 人中的 54 人)。统计分析表明,年龄小于 35 岁、缺乏海外经验、移民身份不稳定、居住时间较短和自行用药是阻碍缅甸移民获得初级卫生保健服务的主要障碍。这些发现得到了深入访谈的证实。

结论

我们的研究发现,拥有获得初级卫生保健的正式途径并不足以确保 GP 注册和医疗保健的使用。一些受访者在注册全科医生实践方面遇到困难。许多已经注册的人更喜欢选择自我用药而不是使用 GP 服务,部分原因是等待时间长和语言障碍。为了确保移民能够享受他们需要和应得的卫生服务,需要采取更积极的措施,包括那些使卫生服务具有文化响应性的措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abba/2970605/9af9f2d41dad/1472-6963-10-285-1.jpg

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