丹麦具有移民背景患者在原籍地区的医疗服务利用情况：动机的定性研究
Use of healthcare services in the region of origin among patients with an immigrant background in Denmark: a qualitative study of the motives.
作者信息
Lokdam Nicoline, Kristiansen Maria, Handlos Line Neerup, Norredam Marie
机构信息
Section of Immigrant Medicine, Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
Research Centre for Migration, Ethnicity and Health, Institute of Public Health, University of Copenhagen, Oster Farimagsgade 5, 1014, Copenhagen K, Denmark.
出版信息
BMC Health Serv Res. 2016 Mar 21;16:99. doi: 10.1186/s12913-016-1346-1.
BACKGROUND
In Denmark, immigrants have been found to have a higher use of healthcare services abroad. Since this use may have an impact on both the individual patient and the healthcare system in the country of residence, research into underlying reasons is of increasing relevance. This study therefore investigates what motives patients with an immigrant background have for seeking healthcare services in their region of origin.
METHODS
The study was based on 10 semi-structured interviews with 10 patients who had an immigrant background, primarily originating from Turkey and the Middle East, recruited at a clinic of immigrant medicine in Denmark. The interviews were analysed thematically to elucidate motives for seeking healthcare services abroad, with focus on identifying push and pull factors.
RESULTS
Four motives for seeking healthcare in the region of origin were salient in the material: the perception of availability, in terms of quantity and access; familiarity, conceptualised as feeling comfortable within the healthcare system; perception of quality of services; and finally, the perceived need for a second opinion. All motives emerged simultaneously as push factors, motivating immigrants to explore healthcare services abroad, and pull factors, attracting them to their country of origin. Affordability did not emerge as an independent motive but influenced the other factors.
CONCLUSION
The use of healthcare services abroad by patients with an immigrant background constitutes active health-seeking behaviours shaped by a range of factors perceived to be limiting access to high-quality services in Denmark. Further research, including quantitative studies, should be initiated to investigate the importance of these motives among larger, more diverse immigrant groups, consequences for treatment regimes, and the healthcare professionals' perspective on the use of healthcare in the region of origin among immigrant patients.
背景
在丹麦，已发现移民在国外使用医疗服务的频率更高。由于这种使用可能会对个体患者以及居住国的医疗系统产生影响，因此对潜在原因的研究愈发重要。本研究因此调查了具有移民背景的患者在其原籍地寻求医疗服务的动机。
方法
该研究基于对10名具有移民背景的患者进行的10次半结构化访谈，这些患者主要来自土耳其和中东地区，是在丹麦一家移民医学诊所招募的。对访谈进行了主题分析，以阐明在国外寻求医疗服务的动机，重点是识别推动因素和拉动因素。
结果
在资料中，在原籍地寻求医疗服务的四个动机较为突出：在数量和可及性方面对可获得性的认知；熟悉度，具体表现为在医疗系统中感觉舒适；对服务质量的认知；最后是对获得第二种意见的感知需求。所有动机同时呈现为推动因素，促使移民在国外探索医疗服务，以及拉动因素，吸引他们前往原籍国。可负担性并未作为一个独立的动机出现，但影响了其他因素。
结论
具有移民背景的患者在国外使用医疗服务构成了积极的求医行为，这些行为受到一系列因素的影响，这些因素被认为限制了在丹麦获得高质量服务的机会。应开展进一步研究，包括定量研究，以调查这些动机在更大、更多样化的移民群体中的重要性、对治疗方案的影响以及医疗专业人员对移民患者在原籍地使用医疗服务的看法。
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