Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padova, Padova, Italy.
Epidemiology Unit, Regione Piemonte, Grugliasco (TO) ASL TO3, Italy.
Eur J Public Health. 2017 Oct 1;27(5):861-868. doi: 10.1093/eurpub/ckx113.
The numbers of migrants living in Europe are growing rapidly, and has become essential to assess their access to primary health care (PHC). Avoidable Hospitalization (AH) rates can reflect differences across migrant and ethnic minority groups in the performance of PHC. We aimed to conduct a systematic review of all published studies on AH comparing separately migrants with natives or different racial/ethnic groups, in Europe and elsewhere.
We ran a systematic search for original articles indexed in primary electronic databases on AH among migrants or ethnic minorities. Studies presenting AH rates and/or rate ratios between at least two different ethnic minority groups or between migrants and natives were included.
Of the 35 papers considered in the review, 28 (80%) were conducted in the United States, 4 in New Zealand, 2 in Australia, 1 in Singapore, and none in Europe. Most of the studies (91%) used a cross-sectional design. The exposure variable was defined in almost all articles by ethnicity, race, or a combination of the two; country of birth was only used in one Australian study. Most of the studies found significant differences in overall AH rates, with minorities (mainly Black and Hispanics) showing higher rates than non-Hispanic Whites.
AH has been used, mostly in the US, to compare different racial/ethnic groups, while it has never been used in Europe to assess migrants' access to PHC. Studies comparing AH rates between migrants and natives in European settings can be helpful in filling this lack of evidence.
在欧洲生活的移民人数正在迅速增长，评估他们获得初级卫生保健（PHC）的机会变得至关重要。可避免住院率（AH）可以反映出 PHC 中移民和少数族裔群体之间的差异。我们旨在对所有在欧洲和其他地区比较移民与本地人或不同种族/族裔群体之间 AH 的已发表研究进行系统综述。
我们在主要电子数据库中针对 AH 对移民或少数民族的原始文章进行了系统搜索。纳入了至少比较两个不同少数民族群体或移民与本地人群之间 AH 率和/或率比的研究。
在综述中考虑的 35 篇论文中，28 篇（80%）在美国进行，4 篇在新西兰，2 篇在澳大利亚，1 篇在新加坡，而在欧洲没有。大多数研究（91%）采用了横断面设计。暴露变量几乎在所有文章中都通过族裔、种族或两者的组合来定义；只有一项澳大利亚研究使用了出生国。大多数研究发现总体 AH 率存在显著差异，少数群体（主要是黑人和西班牙裔）的比率高于非西班牙裔白人。
AH 已被广泛用于比较不同种族/族裔群体，而在欧洲，它从未被用于评估移民获得 PHC 的机会。在欧洲背景下比较移民与本地人群 AH 率的研究可以有助于填补这一证据空白。
