Jervelund Signe Smith, Maltesen Thomas, Wimmelmann Camilla Lawaetz, Petersen Jørgen Holm, Krasnik Allan
1 Department of Public Health, Section for Health Services Research, Danish Research Centre for Migration, Ethnicity, and Health, University of Copenhagen, Copenhagen K, Denmark.
2 Department of Public Health, Section for Biostatistics, University of Copenhagen, Copenhagen K, Denmark.
Scand J Public Health. 2017 Mar;45(2):161-174. doi: 10.1177/1403494816685936. Epub 2017 Jan 12.
Suboptimal healthcare utilisation and lower satisfaction with the patient-doctor encounter among immigrants has been documented. Immigrants' lack of familiarity with the healthcare system has been proposed as an explanation for this. This study investigated whether a systematic delivery of information affected immigrants' knowledge of and satisfaction with the Danish healthcare system.
A prospective, randomised intervention study of 1158 adult immigrants attending two language schools in Copenhagen was conducted. Two intervention groups received written information or a 12-hour course on the Danish healthcare system, while a control group received nothing. Survey data included self-assessed knowledge, true/false questions on access and questions relating to satisfaction with the healthcare system. Data were linked to socioeconomic registry data. Logistic regression analyses were performed.
The course improved knowledge of who to contact in the event of an accident (odds ratio (OR) = 2.67, 95% confidence interval (CI) = 1.56-4.59) but not in the event of illness. Further, it positively affected correct answers for nine out of 11 questions on the healthcare system (varying from OR = 1.87, 95% CI = 1.08-3.24 to OR = 3.11, 95% CI = 1.58-6.11). Written information positively affected correct answers for three out of 11 questions, but negatively affected one out of 11 compared with the control group. Neither intervention affected immigrants' satisfaction with the healthcare system.
Knowledge of the healthcare system is necessary for optimal healthcare-seeking behaviour. The results may form the basis of national and international changes in immigrant reception and optimise immigrants' contact with the healthcare system.
已有文献记载，移民在医疗保健利用方面存在不足，且对医患互动的满意度较低。有人提出，移民对医疗保健系统缺乏了解是造成这种情况的一个原因。本研究调查了系统地提供信息是否会影响移民对丹麦医疗保健系统的了解及满意度。
对哥本哈根两所语言学校的1158名成年移民进行了一项前瞻性随机干预研究。两个干预组分别收到了关于丹麦医疗保健系统的书面信息或参加了为期12小时的课程，而对照组未接受任何信息。调查数据包括自我评估的知识、关于就医途径的是非题以及与医疗保健系统满意度相关的问题。数据与社会经济登记数据相关联。进行了逻辑回归分析。
该课程提高了在发生事故时知道联系谁的知识（优势比（OR）=2.67，95%置信区间（CI）=1.56 - 4.59），但在生病时并未提高。此外，它对医疗保健系统11个问题中的9个问题的正确回答产生了积极影响（OR值从1.87，95%CI = 1.08 - 3.24到OR = 3.11，95%CI = 1.58 - 6.11不等）。书面信息对11个问题中的3个问题的正确回答产生了积极影响，但与对照组相比，对11个问题中的1个问题产生了负面影响。两种干预措施均未影响移民对医疗保健系统的满意度。
了解医疗保健系统对于最佳的就医行为是必要的。这些结果可能成为国家和国际上改变移民接待方式的基础，并优化移民与医疗保健系统的接触。
