Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany.
BMC Health Serv Res. 2022 Aug 17;22(1):1050. doi: 10.1186/s12913-022-08419-y.
Approximately every fourth person in Germany has a migration background. Health research on the use of primary and specialist health care in this group is still scarce. Few studies have suggested a difference in the use of primary and specialist health care among people with a migration background. Potential resources and barriers to health care access should be investigated as they are critical to health equity. This study investigates associated sociodemographic, migration-sensitive, and health-related factors of primary and specialist health care utilization among people with a migration background as defined by nationality.
Analyses are based on data from a feasibility study of the project "Improving Health Monitoring in Migrant Populations" (IMIRA), conducted by the Robert Koch Institute. The sample (n = 1055) included persons with Croatian, Polish, Romanian, Syrian, and Turkish nationalities living in the federal states of Berlin and Brandenburg, Germany. Descriptive and bivariate analyses as well as multiple binary logistic regression analyses were carried out to assess sociodemographic (sex, age, socioeconomic position), health-related (self-rated health), and migration-sensitive factors (duration of residence in Germany, residence status, German language proficiency) associated with the use of primary and specialist health care services in the past 12 months.
Of the total study population, 79.62% visited a general practitioner and 59.53% a specialized physician in the past 12 months. Participants who were female sex, aged 65 and older, and with moderate/poor/very poor self-rated health had higher odds of visiting a general practitioner and a specialized physician, with the strongest impact from self-rated health. After controlling for sociodemographic and health-related factors, duration of residence in Germany and residence status were associated with primary but not with specialist health care utilization.
Our results suggest that migration-sensitive characteristics, such as duration of residence, should be considered in a differentiated manner in health services research to gain detailed insights into health care utilization and its potential barriers among the heterogenous group of people with a migration background. Further research needs to be done to evaluate how to get people into contact with a general practitioner.
在德国，大约每四个人中就有一个人有移民背景。关于这一群体使用初级和专科医疗保健的健康研究仍然很少。很少有研究表明，有移民背景的人在使用初级和专科医疗保健方面存在差异。应该调查潜在的医疗保健获取资源和障碍，因为它们是健康公平的关键。本研究调查了按国籍定义的具有移民背景的人群中初级和专科医疗保健利用的相关社会人口统计学、移民敏感和与健康相关的因素。
分析基于罗伯特·科赫研究所开展的“改善移民人群健康监测”（IMIRA）项目可行性研究的数据。样本（n=1055）包括居住在德国柏林和勃兰登堡州的具有克罗地亚、波兰、罗马尼亚、叙利亚和土耳其国籍的人。进行描述性和双变量分析以及多二元逻辑回归分析，以评估社会人口统计学（性别、年龄、社会经济地位）、与健康相关的因素（自我评估的健康）和移民敏感因素（在德国居住的时间、居住状况、德语熟练程度）与过去 12 个月中使用初级和专科医疗保健服务的情况相关。
在总研究人群中，79.62%的人在过去 12 个月内看过全科医生，59.53%的人看过专科医生。女性、65 岁及以上、自我评估健康状况为中等/差/非常差的参与者看全科医生和专科医生的可能性更高，自我评估健康状况的影响最大。在控制了社会人口统计学和与健康相关的因素后，在德国居住的时间和居住状况与初级保健相关，但与专科保健无关。
我们的研究结果表明，在健康服务研究中，应根据移民敏感特征（如在德国居住的时间）进行差异化考虑，以深入了解具有移民背景的人群中医疗保健的利用情况及其潜在障碍。需要进一步研究如何让人们与全科医生取得联系。
