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Impact of immigration on the cost of emergency visits in Barcelona (Spain)

BACKGROUND: The impact of immigration on health services utilisation has been analysed by several studies performed in countries with lower levels of immigration than Spain. These studies indicate that health services utilisation is lower among the immigrant population than among the host population...

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Autores principales: Cots, Francesc, Castells, Xavier, García, Oscar, Riu, Marta, Felipe, Aida, Vall, Oriol
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1783650/
https://www.ncbi.nlm.nih.gov/pubmed/17239236
http://dx.doi.org/10.1186/1472-6963-7-9
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author Cots, Francesc
Castells, Xavier
García, Oscar
Riu, Marta
Felipe, Aida
Vall, Oriol
author_facet Cots, Francesc
Castells, Xavier
García, Oscar
Riu, Marta
Felipe, Aida
Vall, Oriol
author_sort Cots, Francesc
collection PubMed
description BACKGROUND: The impact of immigration on health services utilisation has been analysed by several studies performed in countries with lower levels of immigration than Spain. These studies indicate that health services utilisation is lower among the immigrant population than among the host population and that immigrants tend to use hospital emergency services at the expense of primary care. We aimed to quantify the relative over-utilisation of emergency services in the immigrant population. METHODS: Emergency visits to Hospital del Mar in Barcelona in 2002 and 2003 were analysed. The country of origin, gender, age, discharge-related circumstances (hospital admission, discharge to home, or death), medical specialty, and variable cost related to medical care were registered. Immigrants were grouped into those from high-income countries (IHIC) and those from low-income countries (ILIC) and the average direct cost was compared by country of origin. A multivariate linear mixed model of direct costs was adjusted by country of origin (classified in five groups) and by the individual variables of age, gender, hospital admission, and death as a cause of discharge. Medical specialty was considered as a random effect. RESULTS: With the exception of gynaecological emergency visits, costs resulting from emergency visits by both groups of immigrants were lower than those due to visits by the Spanish-born population. This effect was especially marked for emergency visits by adults. CONCLUSION: Immigrants tend to use the emergency department in preference to other health services. No differences were found between IHIC and ILIC, suggesting that this result was due to the ease of access to emergency services and to lack of knowledge about the country's health system rather than to poor health status resulting from immigrants' socioeconomic position. The use of costs as a variable of complexity represents an opportunistic use of a highly exhaustive registry, which is becoming ever more frequent in hospitals and which overcomes the lack of clinical information related to outpatient activity.
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spelling pubmed-17836502007-01-27 Impact of immigration on the cost of emergency visits in Barcelona (Spain) Cots, Francesc Castells, Xavier García, Oscar Riu, Marta Felipe, Aida Vall, Oriol BMC Health Serv Res Research Article BACKGROUND: The impact of immigration on health services utilisation has been analysed by several studies performed in countries with lower levels of immigration than Spain. These studies indicate that health services utilisation is lower among the immigrant population than among the host population and that immigrants tend to use hospital emergency services at the expense of primary care. We aimed to quantify the relative over-utilisation of emergency services in the immigrant population. METHODS: Emergency visits to Hospital del Mar in Barcelona in 2002 and 2003 were analysed. The country of origin, gender, age, discharge-related circumstances (hospital admission, discharge to home, or death), medical specialty, and variable cost related to medical care were registered. Immigrants were grouped into those from high-income countries (IHIC) and those from low-income countries (ILIC) and the average direct cost was compared by country of origin. A multivariate linear mixed model of direct costs was adjusted by country of origin (classified in five groups) and by the individual variables of age, gender, hospital admission, and death as a cause of discharge. Medical specialty was considered as a random effect. RESULTS: With the exception of gynaecological emergency visits, costs resulting from emergency visits by both groups of immigrants were lower than those due to visits by the Spanish-born population. This effect was especially marked for emergency visits by adults. CONCLUSION: Immigrants tend to use the emergency department in preference to other health services. No differences were found between IHIC and ILIC, suggesting that this result was due to the ease of access to emergency services and to lack of knowledge about the country's health system rather than to poor health status resulting from immigrants' socioeconomic position. The use of costs as a variable of complexity represents an opportunistic use of a highly exhaustive registry, which is becoming ever more frequent in hospitals and which overcomes the lack of clinical information related to outpatient activity. BioMed Central 2007-01-19 /pmc/articles/PMC1783650/ /pubmed/17239236 http://dx.doi.org/10.1186/1472-6963-7-9 Text en Copyright © 2007 Cots et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Cots, Francesc
Castells, Xavier
García, Oscar
Riu, Marta
Felipe, Aida
Vall, Oriol
Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title_full Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title_fullStr Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title_full_unstemmed Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title_short Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title_sort impact of immigration on the cost of emergency visits in barcelona (spain)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1783650/
https://www.ncbi.nlm.nih.gov/pubmed/17239236
http://dx.doi.org/10.1186/1472-6963-7-9
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