Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
BMJ Open. 2016 Oct 13;6(10):e012101. doi: 10.1136/bmjopen-2016-012101.
Health status, disease spectrum and use of healthcare have been reported to vary across groups of migrants and according to the different phases of migration. However, most studies are conducted among adults. This study assesses usage of primary healthcare (PHC) by children with immigrant background compared with non-immigrant children in Norway and describes their relative morbidity burden.
Population-based retrospective cohort study.
This study used 3 linked population-based registers in Norway for children under 18 years of age in 2008.
Immigrants were defined as children with both parents born abroad, and further classified into first and second generation, and according to the World Bank income categories of their parents' country of origin. Usage and morbidity were assessed with negative binomial regression and logistic regression analyses, respectively. Further, population-attributable fraction analyses on PHC visits were conducted to estimate the impact on the primary health system.
1 168 365 children including 119 251 with immigrant background.
The mean number of visits to PHC for non-immigrant children was 1.40 compared with 1.19 for immigrants from high-income countries (HIC) and 1.76 for immigrants from low-income countries (LIC). Compared with non-immigrants, first generation immigrants used PHC significantly less after adjusting for age and sex (incidence risk ratio (IRR) 0.70 (HIC) to 0.93 (LIC)) while second generation immigrant children generally used PHC more (IRR 1.03 (HIC) to 1.43 (LIC)); however, the median number of visits were similar between all groups. The morbidity spectrum also varied between the groups.
Compared with non-immigrants, the excess number of consultations attributable to immigrant groups corresponds to around 1.3% of PHC visits among children.
健康状况、疾病谱以及医疗保健的使用情况据报道因移民群体的不同以及移民阶段的不同而有所差异。然而，大多数研究都是针对成年人进行的。本研究评估了挪威移民背景儿童与非移民儿童相比对初级保健（PHC）的使用情况，并描述了他们相对的发病负担。
基于人群的回顾性队列研究。
本研究使用了挪威的 3 个基于人群的登记处，对 2008 年 18 岁以下的儿童进行了研究。
移民被定义为父母双方均出生在国外的儿童，并进一步分为第一代和第二代移民，并根据其父母原籍国的世界银行收入类别进行分类。使用负二项式回归和逻辑回归分析分别评估使用情况和发病情况。此外，还进行了 PHC 就诊的人群归因分数分析，以评估对初级卫生系统的影响。
包括 119251 名移民背景儿童在内的 1168365 名儿童。
非移民儿童 PHC 就诊的平均次数为 1.40 次，而高收入国家（HIC）移民为 1.19 次，低收入国家（LIC）移民为 1.76 次。与非移民相比，在调整了年龄和性别后，第一代移民使用 PHC 的次数明显减少（移民与非移民相比的发病率风险比（IRR）分别为 0.70（HIC）至 0.93（LIC）），而第二代移民儿童通常使用 PHC 的次数更多（IRR 为 1.03（HIC）至 1.43（LIC））；然而，所有组的中位数就诊次数相似。各群体的发病谱也存在差异。
与非移民相比，移民群体就诊次数的超额部分相当于儿童 PHC 就诊次数的 1.3%左右。
