Barlow Peter, Mohan Gretta, Nolan Anne
Economic and Social Research Institute, Dublin, Ireland.
Department of Economics, Trinity College, Dublin, Ireland.
J Migr Health. 2021 Nov 26;5:100076. doi: 10.1016/j.jmh.2021.100076. eCollection 2022.
While there is a broad consensus that barriers to access in the utilisation of healthcare exist for immigrants in the US, European evidence exploring this issue paints a mixed picture, with studies from a variety of European jurisdictions presenting different conclusions. In this context, Ireland, a European country with substantial private involvement in healthcare delivery, and, a largely young immigrant population, provides an opportunity to investigate the healthcare utilisation of immigrants compared to natives in a European country with mixed private-public healthcare provision.
The healthcare utilisation patterns of immigrants (defined as residents with a foreign country of birth) and native-born participants were analysed from a nationally representative health survey of 6,326 adults, carried out in Ireland in 2016. An array of socio-economic and health information was collected such that regression analysis on healthcare consultations accounted for confounding factors.
Non-native residents of Ireland born outside the UK were less likely to have attended a General Practitioner (Odds ratio (OR): 0.62 [95% Confidence Interval (CI): 0.51-0.74]; <0.001) or consultant doctor (OR: 0.60 [95% CI: 0.47-0.76]; <0.001) in the previous year, relative to Irish-born individuals. UK-born residents of Ireland displayed similar utilisation patterns to those of the native population in terms of GP visitation, but a higher likelihood of having attended a consultant (OR: 1.44 [95% CI: 1.14-1.816]; = 0.004).
Lower use of healthcare by those born outside Ireland and the UK relative to the native Irish population may be due to different approaches to healthcare utilisation or obstacles to healthcare utilisation. The findings suggest that the utilisation of healthcare by immigrants merits continued policy attention to respond to the needs of these key groups in society and facilitate integration.
虽然人们普遍认为美国的移民在利用医疗保健方面存在获取障碍,但欧洲关于这一问题的证据呈现出复杂的情况,来自欧洲不同司法管辖区的研究得出了不同的结论。在这种背景下,爱尔兰作为一个在医疗保健服务中有大量私人参与且移民人口主要为年轻人的欧洲国家,为调查在公私混合医疗保健提供体系下,与本国居民相比移民的医疗保健利用情况提供了一个机会。
对2016年在爱尔兰进行的一项具有全国代表性的针对6326名成年人的健康调查中移民(定义为出生在外国的居民)和本土出生参与者的医疗保健利用模式进行了分析。收集了一系列社会经济和健康信息,以便在对医疗咨询进行回归分析时考虑混杂因素。
出生在英国以外的爱尔兰非本土居民在前一年看全科医生(优势比(OR):0.62 [95%置信区间(CI):0.51 - 0.74];<0.001)或专科医生(OR:0.60 [95% CI:0.47 - 0.76];<0.001)的可能性低于爱尔兰出生的个人。在爱尔兰出生在英国的居民在看全科医生方面的利用模式与本土人口相似,但看专科医生的可能性更高(OR:1.44 [95% CI:1.14 - 1.816];= 0.004)。
出生在爱尔兰和英国以外的人相对于爱尔兰本土人口对医疗保健的利用率较低,可能是由于医疗保健利用方式不同或存在医疗保健利用障碍。研究结果表明,移民的医疗保健利用情况值得政策持续关注,以满足这些社会关键群体的需求并促进融合。