NR. Foundation Year 2 Doctor, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Board On Health Sciences Policy, The National Academies of Sciences, Engineering, and Medicine, 500 5Th St NW, Washington, D.C., 20001, USA.
BMC Public Health. 2023 Feb 28;23(1):403. doi: 10.1186/s12889-023-15230-9.
The NHS Charges to Overseas Visitors Regulations 2015 outline when healthcare costs should be recuperated from overseas visitors in England. National and global stakeholders have expressed concerns that charging may exacerbate health inequalities and undermine public health efforts especially among vulnerable migrant groups. This review aims to systematically describe the evidence regarding the impact of NHS charging regulations on healthcare access and utilisation and health outcomes for migrants in England.
A systematic search of scientific databases and grey literature sources was performed. Quantitative and qualitative studies, case studies and grey literature published between 1 January 2014 and 1 April 2021 were included. Screening, data extraction and quality appraisal were carried out in accordance with PRISMA guidelines.
From the 1,459 identified studies, 10 were selected for inclusion. 6 were qualitative, 3 were mixed methods and 1 was quantitative. The evidence is lacking but suggests that fears of charging and data sharing can deter some migrants from accessing healthcare. There is also evidence to suggest a lack of knowledge of the charging regulations among patients and healthcare professionals is contributing to this deterrence.
Further independent research supported by strengthening of data collection is required to better understand the effects of charging on healthcare and health outcomes among vulnerable migrants. Our findings support improved training and communication about NHS Charging Regulations for patients and professionals.
2015 年《英国国民保健服务海外访客收费规定》概述了在英格兰向海外访客收取医疗费用的情况。国家和全球利益相关者表示担心，收费可能会加剧健康不平等，并破坏公共卫生工作，尤其是弱势群体移民群体。本综述旨在系统描述有关 NHS 收费规定对移民在英获得医疗服务和利用情况以及健康结果的影响的证据。
对科学数据库和灰色文献来源进行了系统检索。纳入了 2014 年 1 月 1 日至 2021 年 4 月 1 日期间发表的定量和定性研究、案例研究和灰色文献。根据 PRISMA 指南进行了筛选、数据提取和质量评估。
从 1459 项已确定的研究中，选择了 10 项进行纳入。其中 6 项为定性研究，3 项为混合方法研究，1 项为定量研究。证据不足，但表明对收费和数据共享的担忧可能会阻止一些移民获得医疗服务。也有证据表明，患者和医疗保健专业人员对收费规定缺乏了解也是导致这种抵制的原因之一。
需要进一步进行独立研究，并加强数据收集，以更好地了解收费对弱势移民的医疗和健康结果的影响。我们的研究结果支持为患者和专业人员提供有关 NHS 收费规定的更好的培训和沟通。
