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Socioeconomic determinants affecting the access and utilization of depression care services in immigrants: A population-based study

BACKGROUND: It is imperative to address the health problems faced by immigrants in their destination countries in light of the current magnitude of migration processes worldwide. We aimed to evaluate the socioeconomic determinants of healthcare utilization in immigrants with depression. METHOD: A po...

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Autores principales: Jeong, Sohyun, Kang, Cinoo, Cho, Hyemin, Kang, Hee-Jin, Jang, Sunmee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415893/
https://www.ncbi.nlm.nih.gov/pubmed/30865684
http://dx.doi.org/10.1371/journal.pone.0213020
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author Jeong, Sohyun
Kang, Cinoo
Cho, Hyemin
Kang, Hee-Jin
Jang, Sunmee
author_facet Jeong, Sohyun
Kang, Cinoo
Cho, Hyemin
Kang, Hee-Jin
Jang, Sunmee
author_sort Jeong, Sohyun
collection PubMed
description BACKGROUND: It is imperative to address the health problems faced by immigrants in their destination countries in light of the current magnitude of migration processes worldwide. We aimed to evaluate the socioeconomic determinants of healthcare utilization in immigrants with depression. METHOD: A population-based cohort comprising all immigrants who were eligible for National Health Insurance coverage (permanent residents, marriage immigrants, and naturalized citizens) using the National Health Insurance Claims Database in 2011–2013 was established. Cases were defined as immigrants with new-onset depression. Controls were new-onset Korean patients with depression matched by age, sex, and Charlson comorbidity index in a 1:2 ratio. Appropriateness of care (AOC) was defined as visiting a clinic for depression management at least 3 times in the first 12 weeks and 4 times thereafter until 12 months post-cohort entry. RESULTS: A total of 2,378 immigrants and 4,756 matched Korean patients were identified. Of the immigrants, 30.0% achieved AOC, in contrast to 38.7% of Koreans (p < .0001). Adjusting for possible covariates, AOC was less likely for immigrants (adjusted OR (aOR), 0.760; 95% CI: 0.670–0.863). Medical Aid (aOR, 2.309; 95% CI, 1.479–3.610), rural residence (aOR, 1.536; 95% CI, 1.054–2.237), the presence of a psychiatric comorbidity (aOR, 1.912; 95% CI, 1.484–2.463), and visiting a psychiatrist (aOR, 2.387; 95% CI, 1.821–3.125) were associated with an increased likelihood of AOC in immigrants. CONCLUSION: Socioeconomic determinants included insurance type (Medical Aid and National Health Insurance), place of residence, psychiatric comorbid status, doctor specialty, easy access to medical services (clinic-based), and a SSRI-based treatment regimen. Those predictors should be taken into account when developing healthcare strategies for immigrants.
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spelling pubmed-64158932019-04-02 Socioeconomic determinants affecting the access and utilization of depression care services in immigrants: A population-based study Jeong, Sohyun Kang, Cinoo Cho, Hyemin Kang, Hee-Jin Jang, Sunmee PLoS One Research Article BACKGROUND: It is imperative to address the health problems faced by immigrants in their destination countries in light of the current magnitude of migration processes worldwide. We aimed to evaluate the socioeconomic determinants of healthcare utilization in immigrants with depression. METHOD: A population-based cohort comprising all immigrants who were eligible for National Health Insurance coverage (permanent residents, marriage immigrants, and naturalized citizens) using the National Health Insurance Claims Database in 2011–2013 was established. Cases were defined as immigrants with new-onset depression. Controls were new-onset Korean patients with depression matched by age, sex, and Charlson comorbidity index in a 1:2 ratio. Appropriateness of care (AOC) was defined as visiting a clinic for depression management at least 3 times in the first 12 weeks and 4 times thereafter until 12 months post-cohort entry. RESULTS: A total of 2,378 immigrants and 4,756 matched Korean patients were identified. Of the immigrants, 30.0% achieved AOC, in contrast to 38.7% of Koreans (p < .0001). Adjusting for possible covariates, AOC was less likely for immigrants (adjusted OR (aOR), 0.760; 95% CI: 0.670–0.863). Medical Aid (aOR, 2.309; 95% CI, 1.479–3.610), rural residence (aOR, 1.536; 95% CI, 1.054–2.237), the presence of a psychiatric comorbidity (aOR, 1.912; 95% CI, 1.484–2.463), and visiting a psychiatrist (aOR, 2.387; 95% CI, 1.821–3.125) were associated with an increased likelihood of AOC in immigrants. CONCLUSION: Socioeconomic determinants included insurance type (Medical Aid and National Health Insurance), place of residence, psychiatric comorbid status, doctor specialty, easy access to medical services (clinic-based), and a SSRI-based treatment regimen. Those predictors should be taken into account when developing healthcare strategies for immigrants. Public Library of Science 2019-03-13 /pmc/articles/PMC6415893/ /pubmed/30865684 http://dx.doi.org/10.1371/journal.pone.0213020 Text en © 2019 Jeong et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Jeong, Sohyun
Kang, Cinoo
Cho, Hyemin
Kang, Hee-Jin
Jang, Sunmee
Socioeconomic determinants affecting the access and utilization of depression care services in immigrants: A population-based study
title Socioeconomic determinants affecting the access and utilization of depression care services in immigrants: A population-based study
title_full Socioeconomic determinants affecting the access and utilization of depression care services in immigrants: A population-based study
title_fullStr Socioeconomic determinants affecting the access and utilization of depression care services in immigrants: A population-based study
title_full_unstemmed Socioeconomic determinants affecting the access and utilization of depression care services in immigrants: A population-based study
title_short Socioeconomic determinants affecting the access and utilization of depression care services in immigrants: A population-based study
title_sort socioeconomic determinants affecting the access and utilization of depression care services in immigrants: a population-based study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415893/
https://www.ncbi.nlm.nih.gov/pubmed/30865684
http://dx.doi.org/10.1371/journal.pone.0213020
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