Mipatrini Daniele, Addario Sebastiano Pollina, Bertollini Roberto, Palermo Mario, Mannocci Alice, La Torre Giuseppe, Langley Kate, Dembech Matteo, Barragan Montes Sara, Severoni Santino
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
Sicilian Epidemiological Observatory (DASOE), Palermo, Italy.
Eur J Public Health. 2017 Jun 1;27(3):459-464. doi: 10.1093/eurpub/ckx039.
Access to healthcare services for undocumented migrants is one of the main public health issues currently being debated among European countries. Exclusion from primary healthcare services may lead to serious consequences for migrants' health. We analyzed the risk among undocumented migrants, in comparison with regular migrants, of being hospitalized for preventable conditions in the Region of Sicily (Italy). We performed a hospital-based cross-sectional study of the foreign population hospitalized in the Sicily region between 1 January 2003 and 31 December 2013. The first outcome was the proportion of avoidable hospitalization (AHs) among regular and irregular migrants. Second outcomes were the subcategories of AHs for chronic, acute and vaccine preventable diseases. 85 309 hospital admissions were analyzed. In the hospitalized population, in comparison to regular migrants, undocumented migrants show a higher proportion of hospitalization for diseases preventable through primary and preventive care (AOR1·48, 95%CI 1·37-1·59). The proportion of avoidable hospitalizations associated with the lack of legal status is higher for vaccine preventable conditions (AOR 2·06, 95%CI 1·66-2·56) than for chronic conditions (AOR 1·47, 95%CI 1·42-1·63) and acute conditions (AOR 1·37; 95%CI 1·23-1·53). Between 2003 and 2013, the proportion of avoidable hospitalizations decreased both in regular and undocumented migrants but decreased faster for regular than for undocumented migrants. Undocumented migrants experience higher proportion of hospitalization for preventable conditions in comparison with regular migrants probably due to a lack of access to the national healthcare service. Policies and strategies to involve them in primary healthcare and preventive services should be developed to tackle this inequality.
无证件移民获得医疗保健服务是当前欧洲国家正在讨论的主要公共卫生问题之一。被排除在基本医疗保健服务之外可能会给移民的健康带来严重后果。我们分析了意大利西西里地区无证件移民与正规移民相比，因可预防疾病住院的风险。我们对2003年1月1日至2013年12月31日期间在西西里地区住院的外国人口进行了一项基于医院的横断面研究。第一个结果是正规和非正规移民中可避免住院（AHs）的比例。第二个结果是慢性、急性和疫苗可预防疾病的可避免住院亚类。分析了85309例住院病例。在住院人群中，与正规移民相比，无证件移民因通过初级和预防保健可预防的疾病住院的比例更高（比值比1.48，95%置信区间1.37-1.59）。与缺乏合法身份相关的可避免住院比例在疫苗可预防疾病方面（比值比2.06，95%置信区间1.66-2.56）高于慢性病（比值比1.47，95%置信区间1.42-1.63）和急性病（比值比1.37；95%置信区间1.23-1.53）。2003年至2013年期间，正规和无证件移民中可避免住院的比例均有所下降，但正规移民下降得比无证件移民更快。与正规移民相比，无证件移民因可预防疾病住院的比例更高，这可能是由于无法获得国家医疗服务。应制定政策和战略，让他们参与初级医疗保健和预防服务，以解决这种不平等问题。
