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Castillo-Cañón JC, Bojorquez-Chapela I, Fernández-Niño J, Valbuena-Garcia AM, Acuña-Merchan L. Healthcare-related expenditures among immigrants and non-immigrants living with HIV in colombia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1887-1895. [PMID: 33539654 DOI: 10.1111/hsc.13302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/11/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
The perception that immigrants represent a burden to national health systems can hinder the development of policies for their inclusion in health coverage. In order to inform the development of such policies, data on the healthcare needs and healthcare spending for immigrants is required. The objective of this article is to compare the clinical characteristics and healthcare-related expenditures of Venezuelan immigrants and non-migrants living with HIV in Colombia. We analysed data from the Colombian High-cost Diseases Fund from February 1, 2018 to January 31, 2019, identifying the hospital and non-hospital expenditures per patient for Venezuelan immigrants and non-migrant patients, in both the state-subsidised and the contributory coverage schemes. We employed binomial negative regression models to compare expenditures between the two groups. In the contributory scheme, the average annual per-capita expenditure for immigrants was USD $ 859.07 (SD: ± $793.37) for non-hospital care. For non-migrants, the average costs were 1,796.53. In the state-subsidised scheme expenditures were higher on average, but still lower for immigrants than for non-migrants. After adjusting by clinical and sociodemographic characteristics, non-hospital per capita expenditures were lower for immigrants as compared with non-migrants (25,37% lower in the state-subsidised scheme, and 33,75% lower in the contributory scheme). Hospital expenditures were also lower, but the small sample size limited analysis. To conclude, Venezuelan immigrants living with HIV do not represent a major economic burden to the health system in Colombia. Further studies are required in order to understand if the lower healthcare expenditures of this population are the result of limitations in healthcare access, of clinical characteristics that were not assessed in this study, or of other unmeasured aspects.
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Sánchez-Cantalejo C, Rueda MDM, Saez M, Enrique I, Ferri R, Fuente MDL, Villegas R, Castro L, Barceló MA, Daponte-Codina A, Lorusso N, Cabrera-León A. Impact of COVID-19 on the Health of the General and More Vulnerable Population and Its Determinants: Health Care and Social Survey-ESSOC, Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8120. [PMID: 34360413 PMCID: PMC8345631 DOI: 10.3390/ijerph18158120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/16/2021] [Accepted: 07/27/2021] [Indexed: 12/22/2022]
Abstract
This manuscript describes the rationale and protocol of a real-world data (RWD) study entitled Health Care and Social Survey (ESSOC, Encuesta Sanitaria y Social). The study's objective is to determine the magnitude, characteristics, and evolution of the COVID-19 impact on overall health as well as the socioeconomic, psychosocial, behavioural, occupational, environmental, and clinical determinants of both the general and more vulnerable population. The study integrates observational data collected through a survey using a probabilistic, overlapping panel design, and data from clinical, epidemiological, demographic, and environmental registries. The data will be analysed using advanced statistical, sampling, and machine learning techniques. The study is based on several measurements obtained from three random samples of the Andalusian (Spain) population: general population aged 16 years and over, residents in disadvantaged areas, and people over the age of 55. Given the current characteristics of this pandemic and its future repercussions, this project will generate relevant information on a regular basis, commencing from the beginning of the State of Alarm. It will also establish institutional alliances of great social value, explore and apply powerful and novel methodologies, and produce large, integrated, high-quality and open-access databases. The information described here will be vital for health systems in order to design tailor-made interventions aimed at improving the health care, health, and quality of life of the populations most affected by the COVID-19 pandemic.
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Affiliation(s)
- Carmen Sánchez-Cantalejo
- Andalusian School of Public Health (EASP, Escuela Andaluza de Salud Pública), 18080 Granada, Spain; (C.S.-C.); (A.D.-C.)
- Institute of Biosanitary Research, ibs.Granada. (IBS-E-10), 18080 Granada, Spain
| | - María del Mar Rueda
- Department of Statistics and Operations Research, University of Granada, 18014 Granada, Spain; (M.d.M.R.); (R.F.); (L.C.)
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003 Girona, Spain; (M.S.); (M.A.B.)
- Network Biomedical Research Center of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Iria Enrique
- Andalusian Institute of Statistics and Cartography, 41071 Seville, Spain;
| | - Ramón Ferri
- Department of Statistics and Operations Research, University of Granada, 18014 Granada, Spain; (M.d.M.R.); (R.F.); (L.C.)
| | | | | | - Luis Castro
- Department of Statistics and Operations Research, University of Granada, 18014 Granada, Spain; (M.d.M.R.); (R.F.); (L.C.)
| | - Maria Antònia Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003 Girona, Spain; (M.S.); (M.A.B.)
- Network Biomedical Research Center of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Antonio Daponte-Codina
- Andalusian School of Public Health (EASP, Escuela Andaluza de Salud Pública), 18080 Granada, Spain; (C.S.-C.); (A.D.-C.)
- Institute of Biosanitary Research, ibs.Granada. (IBS-E-10), 18080 Granada, Spain
- Network Biomedical Research Center of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Andalusian Health and Environment Observatory (OSMAN), Andalusian School of Public Health (EASP), 18080 Granada, Spain
| | - Nicola Lorusso
- Health Surveillance Service, Department of Health and Families, Andalusian Regional Government, 41020 Seville, Spain;
| | - Andrés Cabrera-León
- Andalusian School of Public Health (EASP, Escuela Andaluza de Salud Pública), 18080 Granada, Spain; (C.S.-C.); (A.D.-C.)
- Network Biomedical Research Center of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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Intercultural Communication between Long-Stay Immigrants and Catalan Primary Care Nurses: A Qualitative Approach to Rebalancing Power. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062851. [PMID: 33799637 PMCID: PMC7999544 DOI: 10.3390/ijerph18062851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 11/16/2022]
Abstract
There is a gap between the preferences of immigrant patients and their experiences with intercultural communication. This study aims to explore the experiences and perspectives of long-stay immigrants on intercultural communication in encounters with primary care (PC) nurses. Participants were selected by purposive sampling at the Maresme Primary Care Center. A focus group and five in-depth interviews with long-stay immigrants from eight countries were carried out. Data collection was guided by a script previously validated by a group of experts. We conducted a qualitative analysis following Charmaz's approach, and data saturation was reached with 11 patients (one focus group and five interviews). Long-stay immigrants would like closer and more personalized communication exchanges with greater humanity, as well as polite and respectful manners as they perceive signs of an asymmetrical care relationship. Those who had negative communication experiences tried to justify some of the behaviors as a result of having free access to public health services. This is one of the few existing studies from the point of view of long-stay immigrants. Achieving effective intercultural communication requires a process of self-reflection, awareness-raising and commitment, both on a personal and institutional level, to eliminate the asymmetry in the nurse-patient relationship. Nurses should be trained in person-centered intercultural communication.
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