Sarría-Santamera Antonio, Hijas-Gómez Ana Isabel, Carmona Rocío, Gimeno-Feliú Luís Andrés
Red de Investigación en Servicios de Salud y Enfermedades Crónicas, Madrid, Spain.
2National School of Public Health, Institute of Health Carlos III, Madrid, Spain.
Public Health Rev. 2016 Dec 3;37:28. doi: 10.1186/s40985-016-0042-3. eCollection 2016.
Changes in migration patterns that have occurred in recent decades, both quantitative, with an increase in the number of immigrants, and qualitative, due to different causes of migration (work, family reunification, asylum seekers and refugees) require constant u pdating of the analysis of how immigrants access health services. Understanding of the existence of changes in use patterns is necessary to adapt health services to the new socio-demographic reality. The aim of this study is to describe the scientific evidence that assess the differences in the use of health services between immigrant and native populations.
A systematic review of the electronic database MEDLINE (PubMed) was conducted with a search of studies published between June 2013 and February 2016 that addressed the use of health services and compared immigrants with native populations. MeSH terms and key words comprised Health Services Needs and Demands/Accessibility/Disparities/Emigrants and Immigrants/Native/Ethnic Groups. The electronic search was supplemented by a manual search of grey literature. The following information was extracted from each publication: context of the study (place and year), characteristics of the included population (definition of immigrants and their sub-groups), methodological domains (design of the study, source of information, statistical analysis, variables of health care use assessed, measures of need, socio-economic indicators) and main results.
Thirty-six publications were included, 28 from Europe and 8 from other countries. Twenty-four papers analysed the use of primary care, 17 the use of specialist services (including hospitalizations or emergency care), 18 considered several levels of care and 11 assessed mental health services. The characteristics of immigrants included country of origin, legal status, reasons for migration, length of stay, different generations and socio-demographic variables and need. In general, use of health services by the immigrants was less than or equal to the native population, although some differences between immigrants were also identified.
This review has identified that immigrants show a general tendency towards a lower use of health services than native populations and that there are significant differences within immigrant sub-groups in terms of their patterns of utilization. Further studies should include information categorizing and evaluating the diversity within the immigrant population.
近几十年来，移民模式发生了变化，在数量上，移民人数有所增加；在质量上，由于不同的移民原因（工作、家庭团聚、寻求庇护者和难民），需要不断更新对移民如何获得医疗服务的分析。了解使用模式的变化对于使医疗服务适应新的社会人口现实是必要的。本研究的目的是描述评估移民和本地人口在医疗服务使用上差异的科学证据。
对电子数据库MEDLINE（PubMed）进行系统综述，检索2013年6月至2016年2月发表的涉及医疗服务使用并比较移民与本地人口的研究。医学主题词和关键词包括医疗服务需求与需求/可及性/差异/移民和侨民/本地人/种族群体。电子检索辅以对灰色文献的手工检索。从每篇出版物中提取以下信息：研究背景（地点和年份）、纳入人群的特征（移民及其亚组的定义）、方法学领域（研究设计、信息来源、统计分析、评估的医疗保健使用变量、需求衡量、社会经济指标）和主要结果。
纳入36篇出版物，其中28篇来自欧洲，8篇来自其他国家。24篇论文分析了初级保健的使用情况，17篇分析了专科服务的使用情况（包括住院或急诊），18篇考虑了多个护理级别，11篇评估了心理健康服务。移民的特征包括原籍国、法律地位、移民原因、停留时间、不同代际以及社会人口变量和需求。总体而言，移民对医疗服务的使用低于或等于本地人口，尽管也发现了移民之间的一些差异。
本综述发现，移民总体上比本地人口使用医疗服务的倾向更低，并且在移民亚组内部，其使用模式存在显著差异。进一步的研究应包括对移民群体内部多样性进行分类和评估的信息。
