Dobbin Joanna, Milner Adrienne, Dobbin Alexander, Potter Jessica
Centre for Primary Care and Public Health, University College London, Royal Free Hospital, London, NW3 2QG UK.
Department of Health Sciences, College of Health, Medicine and Life Sciences Brunel University London, Uxbridge, UB8 3PH UK.
J Public Health (Oxf). 2022 Mar 7;44(1):e68-e75. doi: 10.1093/pubmed/fdaa207.
In 2017, new regulations in England introduced upfront charging for non-urgent care within the National Health Service (NHS). Individuals from outside the European Economic Area who have not paid the immigration surcharge are chargeable for NHS care at 150% of cost.
A freedom of information (FOI) request was sent to 135 acute non-specialist NHS trusts in England to create a database of overseas visitors charges. This was analysed using multiple linear regression to explore the relationship between sex, age, nationality, ethnicity, urgency and the cost of healthcare.
Of 135 acute non-specialist trusts in England 64 replied, providing a data set of 13 484 patients. Women were found to be invoiced higher amounts than men (P = 0.002). Patients were more likely to be women (63 versus 37% men), and within this group, almost half of patients were of reproductive age, with 47.9% (3165) aged 16-40 years old. Only seven trusts supplied data on urgency, and within these trusts the urgency of treatment was significantly related to cost, with the most urgent (immediately necessary) treatment costing the most (P < 0.001).
This research reflects that that migrant women, and particularly undocumented women, are disproportionately impacted by the NHS charging policies in England.
2017年，英国出台新规定，对国民医疗服务体系（NHS）内的非紧急护理实行预先收费。未缴纳移民附加费的欧洲经济区以外的个人需按医疗费用的150%支付NHS护理费用。
向英格兰135家急性非专科NHS信托机构发送了信息自由（FOI）请求，以创建海外访客收费数据库。使用多元线性回归分析该数据库，以探讨性别、年龄、国籍、种族、紧急程度与医疗费用之间的关系。
在英格兰的135家急性非专科信托机构中，64家做出了回复，提供了13484名患者的数据集。结果发现，女性的收费高于男性（P = 0.002）。患者中女性比例更高（女性占63%，男性占37%），在这一群体中，近一半患者处于育龄期，47.9%（3165名）年龄在16至40岁之间。只有7家信托机构提供了有关紧急程度的数据，在这些信托机构中，治疗的紧急程度与费用显著相关，最紧急（立即需要）的治疗费用最高（P < 0.001）。
本研究表明，移民女性，尤其是无证女性，受到英国NHS收费政策的影响尤为严重。
