Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.
Health Soc Care Community. 2011 Sep;19(5):514-21. doi: 10.1111/j.1365-2524.2011.00996.x. Epub 2011 May 17.
Equity of access to health services is a major concern as it is an important precondition for positive health outcomes. However, inequities in use of health services among immigrant populations persist. Despite the increasing research in the field, patterns of healthcare seeking among immigrant populations and its associated factors are not fully understood. This study aimed to investigate healthcare-seeking patterns among immigrants in Portugal and identify factors associated with utilisation of health services. A cross-sectional study was conducted between October 2008 and May 2009 with a sample of 1,375 immigrants residing in the Lisbon region. Data were collected through a structured questionnaire applied by trained interviewers. Two stepwise logistic regressions were conducted to identify which factors were associated with utilisation of the National Health Service (NHS) and with healthcare seeking for the first time in Portugal at the Primary Health Care service, estimated by calculating odds ratios and 95% confidence intervals. Among participants, around 77% reported having used the NHS; 50% sought health-care for the first time at the Primary Health Care service and 33% at the emergency room. Lower odds of having used the NHS were associated with being male, Brazilian or eastern European compared with being African, and undocumented. Lower odds of having sought health-care for the first time at the Primary Health Care service were associated with being male and undocumented. These results suggest that further efforts are needed to tackle inequalities in access to care and promote the utilisation of health services, particularly among the more vulnerable immigrant groups. Increasing appropriate utilisation of health services, including the primary and preventive care services, may lead to better health outcomes. Immigrants' involvement and participation should be incorporated into the development of health strategies to improve access and utilisation of healthcare services.
卫生服务获取公平性是一个主要关注点，因为它是积极健康结果的重要前提。然而，移民人群在使用卫生服务方面的不平等仍然存在。尽管该领域的研究不断增加，但移民人群的医疗保健寻求模式及其相关因素仍未得到充分了解。本研究旨在调查葡萄牙移民的医疗保健寻求模式，并确定与卫生服务利用相关的因素。这是一项在 2008 年 10 月至 2009 年 5 月期间进行的横断面研究，样本为居住在里斯本地区的 1375 名移民。通过受过培训的访谈员应用结构化问卷收集数据。进行了两次逐步逻辑回归，以确定哪些因素与利用国家卫生服务（NHS）以及在初级保健服务中首次寻求医疗保健相关，通过计算优势比和 95%置信区间来估计。在参与者中，约 77%的人报告曾使用过 NHS；50%的人首次在初级保健服务中寻求医疗保健，33%的人在急诊室寻求医疗保健。与非洲人相比，男性、巴西人或东欧人使用 NHS 的可能性较低，而无证者则更低。在初级保健服务中首次寻求医疗保健的可能性较低，与男性和无证者有关。这些结果表明，需要进一步努力解决获得医疗服务方面的不平等问题，并促进卫生服务的利用，特别是在更脆弱的移民群体中。增加对卫生服务的适当利用，包括初级和预防保健服务，可能会导致更好的健康结果。应将移民的参与和参与纳入卫生战略的制定中，以改善医疗保健服务的获取和利用。
