School of Public Health and Community Medicine, The Institute of Medicine, Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden.
Department of Social Work, University of Gothenburg, Sprängkullsgatan 23, PO Box 720, SE- 405 30, Gothenburg, Sweden.
BMC Health Serv Res. 2021 Aug 17;21(1):830. doi: 10.1186/s12913-021-06837-y.
Undocumented migrants face many hardships in their everyday life such as poor living conditions, discrimination, and lack of access to healthcare. Previous studies have demonstrated considerable health care needs for psychiatric disorders as well as physical diseases. The aim of this paper was to find out the main barriers that undocumented migrants experience in accessing the Swedish healthcare system and to explore their relation with socioeconomic factors.
A cross-sectional study with adult undocumented migrants was performed in the three largest cities of Sweden in 2014-2016. Sampling was done via informal networks. A socioeconomic questionnaire was constructed including 22 barriers to health care. Trained field workers conducted the interviews. A principal component analysis was conducted of all barriers to reveal central components. Then, Pearson's chi-squared test was used to explore the characteristics of undocumented migrants experiencing barriers to care.
Two main components/barriers were extracted: "Fear of being taken by police/authorities", which was related to fear of disclosure by or in relation to seeking health care, and "Structural and psychosocial factors" which was related to practical obstacles or shame of being ill. Lower age (74.1 % vs 56.0 %), lower level of education (75.0 % vs. 45.1 %), and having no children (70.3 % vs. 48.1 %) were significantly related to a higher likelihood of experiencing a barrier.
Fear of deportation and practical and psychosocial factors constitute hinderance of access to healthcare for undocumented migrants in Sweden. This highlights the importance of clear instructions, both to undocumented migrants and health professionals about the right to health care according to the international law on human rights as well as the law of confidentiality.
无证移民在日常生活中面临许多困难，如生活条件差、歧视和无法获得医疗保健。先前的研究表明，精神障碍和身体疾病都有相当大的医疗保健需求。本文旨在找出无证移民在获得瑞典医疗保健系统方面遇到的主要障碍，并探讨其与社会经济因素的关系。
2014-2016 年，在瑞典三个最大的城市对成年无证移民进行了横断面研究。通过非正式网络进行抽样。构建了一个包括 22 个医疗保健障碍的社会经济问卷。经过培训的现场工作人员进行了访谈。对所有障碍进行主成分分析，以揭示核心成分。然后，采用 Pearson 卡方检验探讨有医疗保健障碍的无证移民的特征。
提取出两个主要的障碍/组成部分：“害怕被警察/当局带走”，这与寻求医疗保健时的披露或相关恐惧有关，以及“结构和心理社会因素”，这与实际障碍或患病羞耻感有关。年龄较小（74.1%比 56.0%）、受教育程度较低（75.0%比 45.1%）和没有孩子（70.3%比 48.1%）与更高的障碍体验可能性显著相关。
对驱逐出境的恐惧以及实际和心理社会因素构成了瑞典无证移民获得医疗保健的障碍。这凸显了根据国际人权法和保密法，向无证移民和卫生专业人员明确说明获得医疗保健的权利的重要性。
