Stagg Helen R, Jones Jane, Bickler Graham, Abubakar Ibrahim
TB Section, Respiratory Diseases Department, Health Protection Services, Health Protection Agency, Colindale, UK.
BMJ Open. 2012 Aug 6;2(4). doi: 10.1136/bmjopen-2012-001453. Print 2012.
Uptake of healthcare among migrants is a complex and controversial topic; there are multiple recognised barriers to accessing primary care. Delays in presentation to healthcare services may result in a greater burden on costly emergency care, as well as increased public health risks. This study aimed to explore some of the factors influencing registration of new entrants with general practitioners (GPs).
Retrospective cohort study.
Port health screening at Heathrow and Gatwick airports, primary care.
252 559 new entrants to the UK, whose entry was documented by the port health tuberculosis screening processes at Heathrow and Gatwick. 191 had insufficient information for record linkage.
Registration with a GP practice within the UK, as measured through record linkage with the Personal Demographics Service (PDS) database.
Only 32.5% of 252 368 individuals were linked to the PDS, suggesting low levels of registration in the study population. Women were more likely to register than men, with a RR ratio of 1.44 (95% CI 1.41 to 1.46). Compared with those from Europe, individuals of nationalities from the Americas (0.43 (0.39 to 0.47)) and Africa (0.74 (0.69 to 0.79)) were less likely to register. Similarly, students (0.83 (0.81 to 0.85)), long-stay visitors (0.82 (0.77 to 0.87)) and asylum seekers (0.46 (0.42 to 0.51)) were less likely to register with a GP than other migrant groups.
Levels of registration with GPs within this selected group of new entrants, as measured through record linkage, are low. Migrant groups with the lowest proportion registered are likely to be those with the highest health needs. The UK would benefit from a targeted approach to identify the migrants least likely to register for healthcare and to promote access among both users and service providers.
移民群体的医疗保健获取情况是一个复杂且存在争议的话题；获取初级医疗服务存在多种公认的障碍。延迟就医可能会给成本高昂的急诊护理带来更大负担，同时也会增加公共卫生风险。本研究旨在探讨影响新入境者向全科医生（GP）注册的一些因素。
回顾性队列研究。
希思罗机场和盖特威克机场的港口健康筛查、初级医疗服务。
252559名新入境英国的人员，其入境情况由希思罗机场和盖特威克机场的港口健康结核病筛查流程记录。191人信息不足，无法进行记录链接。
通过与个人人口统计服务（PDS）数据库进行记录链接来衡量在英国全科医生诊所注册的情况。
在252368名个体中，只有32.5%与PDS建立了链接，这表明研究人群中的注册率较低。女性比男性更有可能注册，相对风险（RR）比为1.44（95%置信区间为1.41至1.46）。与来自欧洲的人相比，来自美洲（0.43（0.39至0.47））和非洲（0.74（0.69至0.79））国籍的人注册的可能性较小。同样，学生（0.83（0.81至0.85））、长期访客（0.82（0.77至0.87））和寻求庇护者（0.46（0.42至0.51））比其他移民群体向全科医生注册的可能性更小。
通过记录链接测量，在这一选定的新入境者群体中，向全科医生注册的水平较低。注册比例最低的移民群体可能是健康需求最高的群体。英国将受益于一种有针对性的方法，以识别最不可能注册医疗保健的移民，并促进使用者和服务提供者之间的医疗服务获取。
