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希腊东马其顿和色雷斯地区为流动患者提供的公共医疗服务特点。

Features of public healthcare services provided to migrant patients in the Eastern Macedonia and Thrace Region (Greece).

作者信息

Tsitsakis Christos A, Karasavvoglou Anastasios, Tsaridis Efstathios, Ramantani Georgia, Florou Giannoula, Polychronidou Persefoni, Stamatakis Stamatios

机构信息

Department of Accounting and Finance, School of Business Administration, Technological Educational Institute of Central Greece, Lamia, Greece.

Department of Accountancy and Finance, Eastern Macedonia and Thrace Institute of Technology, Agios Loukas, 65404 Kavala, Greece.

出版信息

Health Policy. 2017 Mar;121(3):329-337. doi: 10.1016/j.healthpol.2016.12.006. Epub 2016 Dec 27.

Abstract

BACKGROUND

The influx of migrants, refugees and asylum-seekers into European Union (EU) countries, especially into Greece, in the last 20 years is an issue of growing concern and requires a rational approach. The aim of this study is to chart the use of public health services by the migrants of the Eastern Macedonia and Thrace Region, which forms the northeastern border of Greece.

METHODS

We collected data from five of the six public hospitals in the specified region, and we carried out a per clinic cross tabulation analysis of admission diagnosis and citizenship variables in order to establish the frequency at which the various diagnoses emerge per distinct group of migrant and non-migrant patients in each clinic. The main limitation of the study was the lack of age-standardised data. An additional analysis of frequencies per clinic focusing on migrant patients yielded hospitalisation frequencies per country of origin. We also performed a t-test to compare the average length of stay per clinic between the two groups. Finally, we utilised our available data to map the insurance status of migrant patients.

RESULTS

The results have indicated that the hospitalisation rate of migrant patients due to chronic medical conditions is statistically significantly lower compared to non-migrant patients, while the opposite is true when looking at accident-related diagnoses, certain infectious diseases and medical conditions pertaining to depression and alcohol abuse. The comparisons of the average length of stay showed no overall differences between migrants and non-migrants. Only 2.04% of the migrant patients were uninsured.

CONCLUSIONS

One of the key issues raised by the influx of migrants settling in host countries is concerned with health policy. The knowledge afforded by the medical parameters that characterise the provision of healthcare to them and the findings of relevant studies can lead to a more efficient identification of health risk factors and more effective prevention and treatment. This knowledge also constitutes a particularly crucial and useful tool to help authorities shape their healthcare policies and modify national health systems, which are currently based on the size and characteristics of indigenous populations, to take into account the different conditions with regard to both the number of patients treated and the epidemiological characteristics of the migrants. A greater appreciation of the particular current and potential roles of non-governmental organisations (NGOs) can help to provide appropriate healthcare services to migrants, refugees and asylum-seekers, especially when these groups are excluded from the public health system.

摘要

背景

过去20年里,移民、难民和寻求庇护者涌入欧盟国家,尤其是希腊,这一问题日益受到关注,需要采取合理的应对方法。本研究旨在描绘东马其顿和色雷斯地区(该地区构成希腊的东北边境)移民对公共卫生服务的使用情况。

方法

我们从指定地区六家公立医院中的五家收集数据,并对入院诊断和公民身份变量进行逐诊所交叉列表分析,以确定每个诊所中不同组别的移民和非移民患者出现各种诊断的频率。该研究的主要局限性在于缺乏年龄标准化数据。针对移民患者对每个诊所的频率进行的额外分析得出了按原籍国划分的住院频率。我们还进行了t检验,以比较两组患者在每个诊所的平均住院时间。最后,我们利用现有数据绘制了移民患者的保险状况图。

结果

结果表明,与非移民患者相比,因慢性疾病住院的移民患者比例在统计学上显著较低,而在与事故相关的诊断、某些传染病以及与抑郁症和酒精滥用相关的疾病方面则相反。平均住院时间的比较显示,移民和非移民之间没有总体差异。只有2.04%的移民患者没有保险。

结论

移民涌入东道国引发的关键问题之一与卫生政策有关。表征为他们提供医疗保健的医学参数以及相关研究结果所提供的知识,能够更有效地识别健康风险因素,并实现更有效的预防和治疗。这些知识也是一个特别关键且有用的工具,有助于当局制定医疗保健政策,并对目前基于本土人口规模和特征的国家卫生系统进行调整,以考虑到在接受治疗的患者数量和移民的流行病学特征方面的不同情况。更好地认识非政府组织当前和潜在的特殊作用,有助于为移民、难民和寻求庇护者提供适当的医疗服务,尤其是当这些群体被排除在公共卫生系统之外时。

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