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Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

BACKGROUND: There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden. ME...

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Autores principales: Calderón-Larrañaga, Amaia, Gimeno-Feliu, Luis A, Macipe-Costa, Rosa, Poblador-Plou, Beatriz, Bordonaba-Bosque, Daniel, Prados-Torres, Alexandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3128023/
https://www.ncbi.nlm.nih.gov/pubmed/21645335
http://dx.doi.org/10.1186/1471-2458-11-432
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author Calderón-Larrañaga, Amaia
Gimeno-Feliu, Luis A
Macipe-Costa, Rosa
Poblador-Plou, Beatriz
Bordonaba-Bosque, Daniel
Prados-Torres, Alexandra
author_facet Calderón-Larrañaga, Amaia
Gimeno-Feliu, Luis A
Macipe-Costa, Rosa
Poblador-Plou, Beatriz
Bordonaba-Bosque, Daniel
Prados-Torres, Alexandra
author_sort Calderón-Larrañaga, Amaia
collection PubMed
description BACKGROUND: There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden. METHODS: This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System(®)). RESULTS: The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix. CONCLUSIONS: Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain.
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spelling pubmed-31280232011-07-01 Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System Calderón-Larrañaga, Amaia Gimeno-Feliu, Luis A Macipe-Costa, Rosa Poblador-Plou, Beatriz Bordonaba-Bosque, Daniel Prados-Torres, Alexandra BMC Public Health Research Article BACKGROUND: There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden. METHODS: This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System(®)). RESULTS: The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix. CONCLUSIONS: Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain. BioMed Central 2011-06-06 /pmc/articles/PMC3128023/ /pubmed/21645335 http://dx.doi.org/10.1186/1471-2458-11-432 Text en Copyright ©2011 Calderón-Larrañaga 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
Calderón-Larrañaga, Amaia
Gimeno-Feliu, Luis A
Macipe-Costa, Rosa
Poblador-Plou, Beatriz
Bordonaba-Bosque, Daniel
Prados-Torres, Alexandra
Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System
title Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System
title_full Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System
title_fullStr Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System
title_full_unstemmed Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System
title_short Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System
title_sort primary care utilisation patterns among an urban immigrant population in the spanish national health system
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3128023/
https://www.ncbi.nlm.nih.gov/pubmed/21645335
http://dx.doi.org/10.1186/1471-2458-11-432
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