Khin Yu Par, Owusu Floret Maame, Nawa Nobutoshi, Surkan Pamela J, Fujiwara Takeo
Department of Public Health, Institute of Science Tokyo, Tokyo, Japan.
Center for Well-being Research Advancement, Institute of Science Tokyo, Japan.
Lancet Reg Health West Pac. 2025 Jan 10;54:101276. doi: 10.1016/j.lanwpc.2024.101276. eCollection 2025 Jan.
While Japan provides universal healthcare, immigrants may experience hampered access to healthcare. A comprehensive review of immigrant healthcare access is also lacking. This systematic review aims to examine barriers and facilitators of healthcare access among immigrants in Japan.
We searched for literature published in English and Japanese until January 9, 2024. Studies were included if they assessed factors influencing any stage of immigrants' healthcare access, such as perceiving needs, seeking, reaching, utilizing healthcare and the consequences of healthcare, as defined by the Levesque framework. We performed a thematic analysis to further identify categories (PROSPERO: CRD42023418554).
After screening 2791 articles, we identified 67 studies (40 quantitative, 23 qualitative, 4 mixed methods) meeting eligibility criteria. Limited healthcare information led immigrants to seek alternative information sources and affected immigrants' perceived healthcare needs. Longer duration of stay improved access to healthcare information. Cultural and healthcare system differences affected healthcare seeking. Reaching and utilizing healthcare were hindered by heavy workloads, undocumented status, financial hardship, and limited insurance but were facilitated by support from family and friends. The healthcare system was often insufficient to support immigrants' language and cultural needs leading to dissatisfaction and poor compliance.
Findings highlight the critical importance of a multidimensional approach to support immigrants in Japan, ranging from improving healthcare information access to creating immigrant-friendly health systems. More research is needed on the healthcare access among vulnerable immigrants, such as undocumented and low-skilled labor immigrants and children.
No specific funding source supported this study.
尽管日本提供全民医疗保健服务，但移民在获取医疗保健方面可能会遇到阻碍。目前也缺乏对移民医疗保健获取情况的全面综述。本系统综述旨在研究日本移民在获取医疗保健方面的障碍和促进因素。
我们检索了截至2024年1月9日以英文和日文发表的文献。如果研究评估了影响移民医疗保健获取任何阶段的因素，如感知需求、寻求、获得、利用医疗保健以及医疗保健的后果（如Levesque框架所定义），则纳入该研究。我们进行了主题分析以进一步确定类别（国际前瞻性系统评价注册库：CRD42023418554）。
在筛选了2791篇文章后，我们确定了67项符合纳入标准的研究（40项定量研究、23项定性研究、4项混合方法研究）。有限的医疗保健信息导致移民寻求其他信息来源，并影响了移民对医疗保健需求的感知。较长的停留时间改善了获取医疗保健信息的机会。文化和医疗保健系统差异影响了寻求医疗保健的行为。繁重的工作量、无合法身份、经济困难和保险有限阻碍了获得和利用医疗保健，但家人和朋友的支持起到了促进作用。医疗保健系统往往不足以支持移民的语言和文化需求，导致不满和依从性差。
研究结果凸显了采取多维度方法支持日本移民的至关重要性，从改善获取医疗保健信息到创建对移民友好的医疗保健系统。需要对无证和低技能劳工移民及儿童等弱势移民的医疗保健获取情况进行更多研究。
本研究无特定资金来源支持。
