Polibienestar Research Institute, University of Valencia, 46010 Valencia, Spain.
International Foundation for Integrated Care, Oxford OX2 6UD, UK.
Int J Environ Res Public Health. 2021 Jul 26;18(15):7901. doi: 10.3390/ijerph18157901.
Discrimination based on ethnicity and the lack of translation services in healthcare have been identified as main barriers to healthcare access. However, the actual experiences of migrant patients in Europe are rarely present in the literature.
The aim of this study was to assess healthcare discrimination as perceived by migrants themselves and the availability of translation services in the healthcare systems of Europe.
A total of 1407 migrants in 10 European Union countries (consortium members of the Mig-HealthCare project) were surveyed concerning healthcare discrimination, access to healthcare services, and need of translation services using an interviewer-administered questionnaire. Migrants in three countries were excluded from the analysis, due to small sample size, and the new sample consisted of N = 1294 migrants. Descriptive statistics and multivariable regression analyses were conducted to investigate the risk factors on perceived healthcare discrimination for migrants and refugees in the EU.
Mean age was 32 (±11) years and 816 (63.26%) participants were males. The majority came from Syria, Afghanistan, Iraq, Nigeria, and Iran. Older migrants reported better treatment experience. Migrants in Italy (0.191; 95% CI [0.029, 0.352]) and Austria (0.167; 95% CI [0.012, 0.323]) scored higher in the Discrimination Scale to Medical Settings (DMS) compared with Spain. Additionally, migrants with better mental health scored lower in the DMS scale (0.994; 95% CI [0.993, 0.996]), while those with no legal permission in Greece tended to perceive more healthcare discrimination compared with migrants with some kind of permission (1.384; 95% CI [1.189, 1.611]), as opposed to Austria (0.763; 95% CI [0.632, 0.922]). Female migrants had higher odds of needing healthcare assistance but not being able to access them compared with males (1.613; 95% CI [1.183, 2.199]). Finally, migrants with chronic problems had the highest odds of needing and not having access to healthcare services compared with migrants who had other health problems (3.292; 95% CI [1.585, 6.837]).
Development of culturally sensitive and linguistically diverse healthcare services should be one of the main aims of relevant health policies and strategies at the European level in order to respond to the unmet needs of the migrant population.
基于种族的歧视以及医疗保健服务中缺乏翻译服务，已被确定为获得医疗保健服务的主要障碍。然而，在文献中很少有关于欧洲移民患者的实际体验。
本研究旨在评估移民自身所感知的医疗保健歧视以及欧洲医疗保健系统中翻译服务的可用性。
使用访谈式问卷调查，对来自欧洲 10 个欧盟国家（Mig-HealthCare 项目的联盟成员）的 1407 名移民进行了有关医疗保健歧视、获得医疗保健服务以及对翻译服务的需求的调查。由于样本量较小，有三个国家的移民被排除在分析之外，新样本包括 N=1294 名移民。采用描述性统计和多变量回归分析，调查欧盟中移民和难民感知到的医疗保健歧视的风险因素。
平均年龄为 32（±11）岁，816 名（63.26%）参与者为男性。他们大多数来自叙利亚、阿富汗、伊拉克、尼日利亚和伊朗。年龄较大的移民报告说他们的治疗体验更好。与西班牙相比，意大利（0.191；95%置信区间[0.029，0.352]）和奥地利（0.167；95%置信区间[0.012，0.323]）的移民在医疗环境歧视量表（DMS）中得分更高。此外，心理健康状况较好的移民在 DMS 量表中的得分较低（0.994；95%置信区间[0.993，0.996]），而与希腊的有某种许可的移民相比，没有合法许可的移民更倾向于认为他们受到更多的医疗保健歧视（1.384；95%置信区间[1.189，1.611]），而与奥地利（0.763；95%置信区间[0.632，0.922]）相反。与男性相比，需要医疗保健帮助但无法获得帮助的女性移民的可能性更高（1.613；95%置信区间[1.183，2.199]）。最后，与有其他健康问题的移民相比，有慢性问题的移民需要并无法获得医疗保健服务的可能性最高（3.292；95%置信区间[1.585，6.837]）。
为了满足移民人口的未满足需求，在欧洲层面制定文化敏感和语言多样化的医疗保健服务应成为相关卫生政策和战略的主要目标之一。
