Fadnes Lars T, Diaz Esperanza
Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
BMJ Open. 2017 Feb 1;7(2):e014641. doi: 10.1136/bmjopen-2016-014641.
Morbidity, use of healthcare and medication use have been reported to vary across groups of migrants and according to the different phases of migration, but little is known about children with immigrant background. In this study, we investigate whether the immigrant children's age of arrival predicts differences in usage of primary healthcare (PHC) and in use of prescribed medication.
This nationwide, population-based study used information for children under 18 years of age in 2008 from three linked registers in Norway. Use of medication was assessed with logistic regression analyses presented with ORs with 95% CIs.
Of 1 168 365 children, 119 251 had immigrant background. The mean number of PHC visits among children aged 10-18 years, was 1.19 for non-immigrants, 1.17 among second generation immigrants, 1.12, 1.05 and 0.83 among first immigrant children who were <5, 5-9 and ≥10 years at arrival in Norway, respectively. Patterns were similar for younger immigrants, and were confirmed with regression models adjusting for age and sex. First generation immigrant children used less of nearly all groups of prescribed medication compared to non-immigrants when adjusting for age and sex (overall OR 0.48 (0.47 to 0.49)), and medication was also generally less used among second generation immigrant children (overall OR 0.92 (0.91 to 0.94)).
Age of arrival predicted PHC usage among children among first-generation children. First-generation immigrant children, particularly those arriving later in adolescence, used PHC less than age corresponding non-immigrant children. Immigrant children used less prescribed medication compared to non-immigrants after adjustment for age and sex.
据报道,移民群体之间以及根据移民的不同阶段,发病率、医疗保健使用情况和药物使用情况存在差异,但对于有移民背景的儿童了解甚少。在本研究中,我们调查移民儿童的抵达年龄是否能预测初级医疗保健(PHC)使用情况和处方药使用情况的差异。
这项基于全国人口的研究使用了2008年挪威三个关联登记处中18岁以下儿童的信息。通过逻辑回归分析评估药物使用情况,并给出带有95%置信区间的比值比(OR)。
在1168365名儿童中,119251名有移民背景。10 - 18岁儿童中,非移民儿童的初级医疗保健就诊平均次数为1.19次,第二代移民儿童为1.17次,第一代移民儿童中,抵达挪威时年龄<5岁、5 - 9岁和≥10岁的儿童分别为1.12次、1.05次和0.83次。年龄较小的移民儿童情况类似,在对年龄和性别进行调整的回归模型中得到了证实。在对年龄和性别进行调整后,第一代移民儿童几乎所有类别的处方药使用量均低于非移民儿童(总体OR为0.48(0.47至0.49)),第二代移民儿童的药物使用量通常也较少(总体OR为0.92(0.91至0.94))。
抵达年龄可预测第一代儿童的初级医疗保健使用情况。第一代移民儿童,尤其是那些在青春期后期抵达的儿童,与同龄非移民儿童相比,使用初级医疗保健的次数较少。在对年龄和性别进行调整后,移民儿童的处方药使用量低于非移民儿童。