Department of Public Health, Section for Health Services Research, Danish Research Centre for Migration, Ethnicity, and Health, University of Copenhagen, Øster Farimagsgade 5A, DK-1014, Copenhagen K, Denmark.
Department of Public Health, Section for Biostatistics, University of Copenhagen, Øster Farimagsgade 5A, DK-1014, Copenhagen K, Denmark.
BMC Public Health. 2018 Jul 11;18(1):863. doi: 10.1186/s12889-018-5741-x.
Immigrants may face problems with accessing the Danish healthcare system due to, for example, lack of knowledge of how to navigate it, which may cause inappropriate healthcare-seeking. Danish municipalities provide a mandatory introduction and language programme for newly arrived immigrants, but no information on the healthcare system is offered. This study investigated what effects information about the Danish healthcare system may have on the hypothetical healthcare-seeking behaviour of newly arrived immigrants and their actual healthcare use.
A prospective intervention study of 1572 adult immigrants attending two language schools in Copenhagen was carried out. Two intervention groups received either a course or written information on the Danish healthcare system, respectively, while the control group received neither. Survey data included three case vignettes on healthcare-seeking behaviour (flu-like symptoms, chest pain and depression) and were linked to registry data on sociodemographic characteristics and healthcare use in the year to follow. Logistic regression and binomial regression analyses were performed.
Appropriate hypothetical healthcare-seeking behaviour was reported by 61.8-78.8% depending on the vignette. Written information showed no effect on immigrants' hypothetical healthcare-seeking behaviour, while the course showed a positive effect on hypothetical healthcare-seeking behaviour for flu-like symptoms (adjusted odds ratio [AOR] = 1.71, 95% confidence interval [CI] = 1.01-2.91, p-value = 0.0467), but not on chest pain or depression. The interventions did not affect immigrants' actual healthcare use; all groups made lower use of health care services in the following year compared with the year where the study took place, except for the use of dental care which remained stable.
Information on the healthcare system embedded in the language school programme has the potential to facilitate immigrants' access to healthcare. Yet, the results underscore the need for further refinement and development of educational interventions, as well as ensuring adequate utilisation of healthcare services by other means. Multi-dimensional and multi-sectional efforts are important for integration issues within healthcare in Europe.
Health-seeking behaviour among newly arrived immigrants in Denmark ISRCTN24905314 , May 1, 2015 (Retrospectively registered).
移民可能由于缺乏对丹麦医疗体系的了解，在使用该体系时存在障碍，从而导致就医不当。丹麦各市政府为新移民提供了强制性的介绍和语言课程，但不提供有关医疗体系的信息。本研究旨在调查有关丹麦医疗体系的信息可能对新移民的假设就医行为以及他们实际的医疗使用产生何种影响。
对哥本哈根两所语言学校的 1572 名成年移民进行了一项前瞻性干预研究。两个干预组分别接受了有关丹麦医疗体系的课程或书面信息，而对照组则未接受任何信息。调查数据包括三种关于就医行为的病例情节（流感样症状、胸痛和抑郁），并与随后一年的社会人口特征和医疗使用登记数据相关联。进行了逻辑回归和二项回归分析。
根据情节的不同，适当的假设就医行为的报告率为 61.8-78.8%。书面信息对移民的假设就医行为没有影响，而课程对流感样症状的假设就医行为有积极影响（调整后的优势比[OR] = 1.71，95%置信区间[CI] = 1.01-2.91，p 值 = 0.0467），但对胸痛或抑郁则没有影响。这些干预措施并未影响移民的实际医疗使用；与研究进行的那一年相比，所有组在次年的医疗服务使用量均有所下降，除了牙科护理的使用量保持稳定。
嵌入语言学校课程中的医疗体系信息有可能促进移民获得医疗服务。然而，结果强调需要进一步改进和发展教育干预措施，并通过其他方式确保充分利用医疗服务。多维和多层面的努力对于欧洲医疗保健中的融合问题至关重要。
丹麦新移民的就医行为 ISRCTN80529614，2015 年 5 月 1 日（回顾性注册）。
