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Camedda C, Righi M. Experiences and Suggestions of Nurses Involved in Caring for Migrant Populations in Italy: A Qualitative Study. Healthcare (Basel) 2024; 12:275. [PMID: 38275555 PMCID: PMC10815452 DOI: 10.3390/healthcare12020275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/14/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
The aim of this research is to explore nurses' experiences in caring for migrants, regular and non-regular, within outpatient clinics in Italy. MATERIALS AND METHODS Thirteen nurses have been interviewed through online semi-structured interviews, conducted with the support of a questionnaire, made by researchers, consisting of open-ended questions on legislative issues, cultural issues, and regarding best practices. Purposive sampling has been used, along with phone and email recruitment. The audio recordings of the interviews were verbatim transcribed, then examined. This study is a qualitative descriptive fundamental research project. RESULTS Interviewees highlight migrants' difficulties in accessing care, critical points of legislation, transcultural skills crucial to nurses, and good practices. A total of 105 labels were developed and grouped into 23 categories under 7 themes (Italian legislation and migrants; structural difficulties in assistance; the influence of politics; the work of NGOs and associations; nursing care; winning strategies; and the role of the Family and Community Nurse). CONCLUSION The research highlights how access to care for migrants is hindered by legislative, structural, and cultural barriers, with consequences on the NHS (improper accesses to the emergency room, increased workload, and economic expenditure). For the full realization of the right to health, as enshrined by Art. 32 of the Constitution, changes are needed with respect to regulations and professionals' training.
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Affiliation(s)
- Claudia Camedda
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Maddalena Righi
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
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Trappolini E, Marino C, Agabiti N, Giudici C, Davoli M, Cacciani L. Disparities in emergency department use between Italians and migrants residing in Rome, Italy: the Rome Dynamic Longitudinal Study from 2005 to 2015. BMC Public Health 2020; 20:1548. [PMID: 33059671 PMCID: PMC7559990 DOI: 10.1186/s12889-020-09280-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 07/20/2020] [Indexed: 01/01/2023] Open
Abstract
Background The Emergency Department (ED) can be considered an indicator of accessibility and quality and can be influenced in period of economic downturns. In the last fifteen years, the number of migrants in Italy has doubled (from 2.4 million in 2005 to 5.2 in 2019, 4.1 and 8.7% of the total population, respectively). However, evidence about migrants’ healthcare use is poor, and no studies focused on the ED utilisation rate during the Great Recession are available. This study aims to analyse trends in all-cause and cause-specific ED utilisation among migrants and Italians residing in Rome, Italy, before and after 2008. Methods Longitudinal study based on data from the Municipal Register of Rome linked to the Emergency Department Register from 2005 to 2015. We analysed 2,184,467 individuals, aged 25–64 in each year. We applied a Hurdle model to estimate the propensity to use the ED and to model how often individuals accessed the ED. Results Migrants were less likely to be ED users than Italians, except for Africans (RR = 1.46, 95%CI 1.40–1.52) and Latin Americans (RR = 1.04, 95%CI 1.00–1.08) who had higher all-cause utilisation rates than non-migrants. Compared to the pre-2008 period, in the post-2008 we found an increase in the likelihood of being an ED user (OR = 1.34, 95%CI 1.34–1.35), and a decrease in ED utilisation rates (RR = 0.96, 95%CI 0.96–0.97) for the whole population, with differences among migrant subgroups, regardless of cause. Conclusions This study shows differences in the ED utilisation between migrants and Italians, and within the migrant population, during the Great Recession. The findings may reflect differentials in the health status, and barriers to access primary and secondary care among migrants. In this regard, health policies and cuts in health spending measures may have played a key role, and interventions to tackle health and access disparities should include policy measures addressing the underlying factors, adopting a Health in All Policies perspective. Further researches focusing on specific groups of migrants, and on the causes and diagnoses related to the ED utilisation, may help to explain the differences observed.
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Affiliation(s)
| | - Claudia Marino
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Nera Agabiti
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Laura Cacciani
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
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Reimers AK, Brzoska P, Niessner C, Schmidt SCE, Worth A, Woll A. Are there disparities in different domains of physical activity between school-aged migrant and non-migrant children and adolescents? Insights from Germany. PLoS One 2019; 14:e0214022. [PMID: 30883609 PMCID: PMC6422267 DOI: 10.1371/journal.pone.0214022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/05/2019] [Indexed: 12/29/2022] Open
Abstract
Background Large proportions of the populations in many European countries, including Germany, are migrants. Migrant children and adolescents tend to be less physically active than their non-migrant peers. However, current research is limited as it does not sufficiently consider different domains of physical activity. Using a representative dataset, the present study examines the patterns of sports participation and other domains of physical activity among migrant and non-migrant children and adolescents residing in Germany. Methods Nationwide data from the Motorik-Modul (MoMo) Study is used. Five different domains of physical activity participation (sports clubs, outside of sports clubs, extra-curricular physical activity, physical activity, outdoor play and active commuting to school) were compared between children and adolescents with no, one-sided and two-sided migration background using logistic regression adjusted for demographic factors. Interaction terms were included in order to examine whether difference between the three groups differ by age and gender. Results Information on n = 3,323 children and adolescents was available. As compared to non-migrants, children and adolescents with a two-sided migration background had a 40% (adjusted odds ratio [aOR] = 0.60, 95%-CI: 0.44–0.81), those with a one-sided migration background a 26% (aOR = 0.74, 95%-CI: 0.55-<1.00) lower chance of participating in sport club activities. In contrast, children and adolescents with a two-sided migration background were at 65% higher chance of participating in extra-curricular physical activity than non-migrants (OR = 1.65, 95%-CI: 1.15–2.36). Conclusion The study shows that differences in levels of physical activity between migrant and non-migrant children and adolescents are less pronounced than previous research has suggested. In particular, it reveals that migrants are only disadvantaged regarding participation in sports clubs whereas they fare better with respect to extra-curricular physical activity. Interventions should therefore address barriers migrant children and adolescents encounter in the access to sport clubs while maintaining their high level of extra-curricular physical activity.
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Affiliation(s)
- Anne K. Reimers
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Technical University of Chemnitz, Chemnitz, Germany
- * E-mail:
| | - Patrick Brzoska
- Health Services Research Unit, Faculty of Health/School of Medicine, Witten/Herdecke University, Witten/Herdecke, Germany
| | - Claudia Niessner
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Steffen C. E. Schmidt
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Annette Worth
- Institute for Movement and Sports, University of Education Karlsruhe, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Rodríguez-Álvarez E, Lanborena N, Borrell LN. Health Services Access Inequalities Between Native and Immigrant in a Southern European Region. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2018; 49:108-126. [PMID: 30388375 DOI: 10.1177/0020731418809858] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With the economic crisis in Spain, austerity measures were applied. However, it is unknown how these measures have affected the pattern of use of health services for the immigrant population. Thus, the objective of this study was to examine the inequalities in access to different levels of health care services according to place of birth. We used data from the 2014 Foreign Immigrant Population Survey (n = 1,908) and the Basque Health Survey 2013 for the native population (n = 4,232) for adults aged 16-59 years residing in the Basque Country, Spain. Log-binomial regression was used to quantify the association between country of origin and use of different levels of care in men and in women. We found a higher probability of using general practitioner (GP) services in immigrant women (PR: 1.19; 95% CI: 1.12-1.26) and men (PR: 1.11; 95% CI: 1.01-1.23) than in natives. This was also true for emergency services with immigrant women (PR: 1.97; 95% CI: 1.43-2.69) and men (PR: 1.50; 95% CI: 1.01-2.25). However, for specialized medicine services, there was no association. This study suggests the importance of guaranteeing access to health care to the entire population. Hence policies to eliminate barriers to health care are essential to ensure health for all.
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Affiliation(s)
- Elena Rodríguez-Álvarez
- 1 Department of Nursing I, University of the Basque Country (UPV/EHU), Leioa, Spain.,2 OPIK-Research Group for Social Determinants of Health and Demographic Change, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Nerea Lanborena
- 1 Department of Nursing I, University of the Basque Country (UPV/EHU), Leioa, Spain.,2 OPIK-Research Group for Social Determinants of Health and Demographic Change, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Luisa N Borrell
- 2 OPIK-Research Group for Social Determinants of Health and Demographic Change, University of the Basque Country (UPV/EHU), Leioa, Spain.,3 Department of Epidemiology and Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, USA
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Henares-Montiel J, Ruiz-Perez I, Mendoza-Garcia O. Health inequalities between male and female immigrants in Spain after the beginning of the economic crisis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:891-897. [PMID: 30014605 DOI: 10.1111/hsc.12613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 06/01/2018] [Accepted: 06/12/2018] [Indexed: 06/08/2023]
Abstract
The aim of this study was to analyse health inequalities in the immigrant population in Spain in 2014, while differentiating between immigrant and native-born men and women. We have designed a cross-sectional study on the population aged over 15 years resident in Spain and the data were obtained from the 2014 European Health Survey in Spain (n = 22,842). Among immigrant men and women, we observed a lower risk of having a Chronic Physical Problem (CPP) or a Mental Health Problem (MHP) and a lower consumption of psychiatric drugs. We also observed a higher risk of lack of medical care in immigrant men compared to native-born. The country of origin was not significantly related to self-perception of health or use of Primary Care (PC) and Emergency Care services. In conclusion, we observed that now that the peak of the crisis has passed it seems that the "healthy immigrant" effect is being recovered, although the gender inequalities observed in the general population are transferred to the immigrant population. We need to approach the feminisation of migration from a new perspective and understand how inequalities affect immigrant women.
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Affiliation(s)
- Jesus Henares-Montiel
- Escuela Andaluza de Salud Pública, Granada, Spain
- UGC Interniveles Prevención Promoción y Vigilancia de la Salud, Granada, Spain
| | - Isabel Ruiz-Perez
- Escuela Andaluza de Salud Pública, Granada, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria (IBS), Granada, Spain
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Dania Rocío DR, Valentín HB, Isabel JT, Pilar CG. Factors Associated to Medication Consumption Among the Immigrant Population Residing in Spain. J Immigr Minor Health 2017; 20:909-919. [PMID: 28597232 DOI: 10.1007/s10903-017-0608-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We aimed to determine the prevalence of medication use by the immigrant population residing in Spain, and to identify the factors associated with this consumption. Descriptive cross-sectional study was performed using secondary data retrieved from the 2012 Spanish National Health Survey (SNHS). Using logistic multivariate regression analysis, three models were generated: one for immigrants from high income countries (HIC), another for immigrants from low income countries (LIC), and a third one for the native population. The prevalence of total consumption of medicinal products is greater in the native population (61.75%) than in the immigrant population (HIC: 56.22%; LIC: 48.55%). Analgesics are the most consumed drugs in all the groups. Greater medication consumption is associated with being female, being of an advanced age (immigrants from HIC: AOR 9.75, for older than 75 years), the presence of chronic disease, a perception of bad health (HIC: AOR 3.48) and the use of emergency services (LIC immigrants: AOR 1.68). Medicine consumption in the immigrant population living in Spain is lower than in the native population. The factors associated with this consumption are similar; however, LIC immigrants who needed healthcare services and did not receive them presented a greater probability of consuming medicinal products.
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Affiliation(s)
| | - Hernández-Barrera Valentín
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avda. Atenas s/n, Alcorcón, Madrid, Spain
| | - Jiménez-Trujillo Isabel
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avda. Atenas s/n, Alcorcón, Madrid, Spain
| | - Carrasco-Garrido Pilar
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avda. Atenas s/n, Alcorcón, Madrid, Spain.
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Sarría-Santamera A, Hijas-Gómez AI, Carmona R, Gimeno-Feliú LA. A systematic review of the use of health services by immigrants and native populations. Public Health Rev 2016; 37:28. [PMID: 29450069 PMCID: PMC5810113 DOI: 10.1186/s40985-016-0042-3] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 11/09/2016] [Indexed: 12/02/2022] Open
Abstract
Background Changes in migration patterns that have occurred in recent decades, both quantitative, with an increase in the number of immigrants, and qualitative, due to different causes of migration (work, family reunification, asylum seekers and refugees) require constant u pdating of the analysis of how immigrants access health services. Understanding of the existence of changes in use patterns is necessary to adapt health services to the new socio-demographic reality. The aim of this study is to describe the scientific evidence that assess the differences in the use of health services between immigrant and native populations. Methods A systematic review of the electronic database MEDLINE (PubMed) was conducted with a search of studies published between June 2013 and February 2016 that addressed the use of health services and compared immigrants with native populations. MeSH terms and key words comprised Health Services Needs and Demands/Accessibility/Disparities/Emigrants and Immigrants/Native/Ethnic Groups. The electronic search was supplemented by a manual search of grey literature. The following information was extracted from each publication: context of the study (place and year), characteristics of the included population (definition of immigrants and their sub-groups), methodological domains (design of the study, source of information, statistical analysis, variables of health care use assessed, measures of need, socio-economic indicators) and main results. Results Thirty-six publications were included, 28 from Europe and 8 from other countries. Twenty-four papers analysed the use of primary care, 17 the use of specialist services (including hospitalizations or emergency care), 18 considered several levels of care and 11 assessed mental health services. The characteristics of immigrants included country of origin, legal status, reasons for migration, length of stay, different generations and socio-demographic variables and need. In general, use of health services by the immigrants was less than or equal to the native population, although some differences between immigrants were also identified. Conclusions This review has identified that immigrants show a general tendency towards a lower use of health services than native populations and that there are significant differences within immigrant sub-groups in terms of their patterns of utilization. Further studies should include information categorizing and evaluating the diversity within the immigrant population.
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Affiliation(s)
- Antonio Sarría-Santamera
- Red de Investigación en Servicios de Salud y Enfermedades Crónicas, Madrid, Spain.,2National School of Public Health, Institute of Health Carlos III, Madrid, Spain.,IMIENS, UNED, Madrid, Spain.,4Faculty of Medicine, University of Alcalá, Alcalá, Spain
| | - Ana Isabel Hijas-Gómez
- University Hospital Fundación Alcorcón, Alcorcón, Spain.,6Agency for Health Technology Assessment, Institute of Health Carlos III, Madrid, Spain
| | - Rocío Carmona
- 2National School of Public Health, Institute of Health Carlos III, Madrid, Spain.,IMIENS, UNED, Madrid, Spain
| | - Luís Andrés Gimeno-Feliú
- Red de Investigación en Servicios de Salud y Enfermedades Crónicas, Madrid, Spain.,7EpiChron Research Group on Chronic Diseases, Aragon Health Sciences Institute (IACS), IIS Aragón, Zaragoza, Spain.,San Pablo Health Centre, Aragonese Health Service, Zaragoza, Spain.,9Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
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Elstad JI. Register study of migrants' hospitalization in Norway: world region origin, reason for migration, and length of stay. BMC Health Serv Res 2016; 16:306. [PMID: 27461121 PMCID: PMC4962451 DOI: 10.1186/s12913-016-1561-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 07/20/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The proportion of migrants and refugees increase in many populations. Health planners have to consider how migration will influence demand for health care. This study explores how migrants' geographical origin, reason for migration, and duration of residence are associated with admission rates to somatic hospitals in Norway. METHODS Sociodemographic information on all individuals residing in Norway at the start of 2008 was linked to data on all admissions to somatic hospitals during 2008-2011. Migrants, age 30-69, who had come to Norway during 1970-2007 (N = 217,907), were classified into seven world region origins and compared with native Norwegians of the same age (N = 2,181,948). Any somatic hospital stay 2008-2011 and number of hospital admissions 2008-2011 per 1000 personyears for a set of somatic diagnoses were analyzed by age and gender standardized rates, linear probability models, and Poisson regression. RESULTS In the native Norwegian sample, 28.7 % had at least one admission 2008-2011, and there were 116 admissions per 1000 personyears. Corresponding age and gender adjusted figures for the migrant sample were 27.0 % and 103 admissions. Admission rates varied with migrants' geographical origin, with relatively many admissions among migrants from West and South Asia and relatively few admissions among migrants from Western, East European, and Other Asian countries. Hospitalization varied strongly with reason for migration, with low admission rates for recent work migrants and high admission rates for recent refugees. Admission rates tended to move towards the level among native Norwegians with increasing length of stay. Among longstanding migrants (arrival period 1970-1989), admission rates were close to the levels of native Norwegians for most analyzed migrant categories. CONCLUSION Both world region origin, reason for migration, and duration of residence are important sources for variations in migrants' utilization of somatic hospitals. Forecasts about migrants' use of hospital services have to take into account how the migrant population is composed as to these three determinants. High admission rates among recently arrived refugees should be a health policy concern.
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Affiliation(s)
- Jon Ivar Elstad
- NOVA, Centre for Welfare and Labour Research, Oslo and Akershus University College of Applied Sciences, P.O.B. 4, St. Olavs Plass, 0130, Oslo, Norway.
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