Immigrant assimilation in health care utilisation in Spain.

Abundant evidence has tracked the labour market and health assimilation of immigrants, including static analyses of differences in how foreign-born and native-born residents consume health care services. However, we know much less about how migrants' patterns of healthcare usage evolve with time of residence, especially in countries providing universal or quasi-universal coverage. We investigate this process in Spain by combining all the available waves of the local health survey, which allows us to separately identify period, cohort, and assimilation effects. We find robust evidence of migrant assimilation in health care use, specifically in visits to general practitioners and emergency care and among foreign-born women. The differential effects of ageing on health care use between foreign-born and native-born populations contributes to the convergence of utilisation patterns in most health services after 15 years in Spain. Substantial heterogeneity by the time of arrival and by region of origin both suggest that studies modelling future welfare state finances would benefit from a more thorough assessment of migration.