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澳大利亚移民家庭儿童的卫生服务利用情况和未满足的医疗保健需求:基于人群的队列研究。

Health service utilisation and unmet healthcare needs of Australian children from immigrant families: A population-based cohort study.

机构信息

Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.

Department of Pediatrics, The University of Melbourne, Melbourne, Australia.

出版信息

Health Soc Care Community. 2020 Nov;28(6):2331-2342. doi: 10.1111/hsc.13054. Epub 2020 Jun 23.

Abstract

Compared with most other Organization for Economic Co-operation and Development (OECD) countries, information about the patterns of health service use for children from immigrant families in Australia is currently limited, and internationally, data on unmet healthcare needs are scarce. This study aims to examine the distribution of health service utilisation and unmet healthcare needs for immigrant children aged 10-11 years in Australia. We drew on data from the Longitudinal Study of Australian Children Birth (B; n = 5,107) and Kindergarten (K; n = 4,983) cohorts. The exposure was family immigration background collected at 0-1 (B-cohort) and 4-5 (K-cohort) years. Outcomes were parent-reported child health service use and unmet healthcare needs (defined as the difference between services needed and services received) at 10-11 years. Logistic regression analyses were used to examine associations between family immigration background and health service use/unmet healthcare needs, adjusting for potential confounders. Results showed that one-third of Australian children (B-cohort: 29.0%; K-cohort: 33.4%) came from immigrant families. There were similar patterns of health service use and unmet healthcare needs between children from English-speaking immigrant and Australian-born families. However, children from non-English-speaking immigrant families used fewer health services, including paediatric, dental, mental health and emergency ward services. There was a disparity between the services used when considering children's health needs, particularly for paediatric specialist services (B-cohort: OR = 2.43, 95% CI 1.11-5.31; K-cohort: OR = 2.72, 95% CI 1.32-5.58). Findings indicate that Australian children from non-English-speaking immigrant families experience more unmet healthcare needs and face more barriers in accessing health services. Further effort is needed to ensure that the healthcare system meets the needs of all families.

摘要

与大多数经济合作与发展组织(OECD)国家相比,目前有关澳大利亚移民家庭儿童卫生服务使用模式的信息有限,在国际上,关于未满足的医疗保健需求的数据也很少。本研究旨在调查澳大利亚 10-11 岁移民儿童的卫生服务利用和未满足的医疗保健需求的分布情况。我们利用了澳大利亚儿童出生(B;n=5107)和幼儿园(K;n=4983)队列的纵向研究数据。暴露因素是在 0-1 岁(B 队列)和 4-5 岁(K 队列)收集的家庭移民背景。结果是父母报告的 10-11 岁儿童卫生服务使用情况和未满足的医疗保健需求(定义为所需服务与所获得服务之间的差异)。使用逻辑回归分析来检验家庭移民背景与卫生服务利用/未满足的医疗保健需求之间的关系,同时调整了潜在的混杂因素。结果显示,三分之一的澳大利亚儿童(B 队列:29.0%;K 队列:33.4%)来自移民家庭。来自英语移民家庭和澳大利亚出生家庭的儿童的卫生服务使用和未满足的医疗保健需求模式相似。然而,来自非英语移民家庭的儿童使用的卫生服务较少,包括儿科、牙科、心理健康和急诊病房服务。在考虑儿童健康需求时,服务的使用存在差异,特别是儿科专科服务(B 队列:OR=2.43,95%CI 1.11-5.31;K 队列:OR=2.72,95%CI 1.32-5.58)。研究结果表明,来自非英语移民家庭的澳大利亚儿童经历更多的未满足的医疗保健需求,并在获得医疗服务方面面临更多障碍。需要进一步努力确保医疗保健系统满足所有家庭的需求。

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