Hospital admissions in Alicante (Spain): a comparative analysis of foreign citizens from high-income countries, immigrants from low-income countries, and Spanish citizens

Injuries Among Immigrants Treated in Primary Care in Madrid, Spain

This study compared the injury incidence rates by sex in adult immigrant and native population attended in primary care in the Community of Madrid, Spain. Cross-sectional study of injuries registered in the primary care electronic medical record in 2012. Crude and age-adjusted incidence rates by sex, region of birth and type of injury were calculated. Poisson regression was performed. In both sexes, the highest crude injury incidence rate was found in immigrants from North Africa, followed by the native population. After controlling for age and socioeconomic-status, the highest risk of injury in immigrants was observed in burns in women from North-African (79%) and in foreign body injuries in men from Latin America and Caribbean, Sub-Saharan and North Africa and Central and Eastern Europe (61-123%). The analysis by region of origin has identified people from North Africa as a particularly vulnerable group.

Utilization of health care services by migrants in Europe-a systematic literature review

INTRODUCTION

Our study reviewed the empirical evidence on the utilization of health care services by migrants in Europe, and on differences in health service utilization between migrants and non-migrants across European countries.

SOURCES OF DATA

A systematic literature review was performed, searching the databases Medline, Cinahl and Embase and covering the period from January 2009 to April 2016. The final number of articles included was 39.

AREAS OF AGREEMENT

Utilization of accident and emergency services and hospitalizations were higher among migrants compared with non-migrants in most countries for which evidence was available. In contrast, screening and outpatient visits for specialized care were generally used less often by migrants.

AREAS OF CONTROVERSY

Utilization of general practitioner services among migrants compared with non-migrants presents a diverging picture.

GROWING POINTS

Compared with previous systematic reviews, the results indicate a clearer picture of the differences in health service utilization between migrants and non-migrants in Europe.

AREAS TIMELY FOR DEVELOPING RESEARCH

A comprehensive comparison across European countries is impossible because the number of studies is still limited. Further research should also help to identify barriers regarding the utilization of health care services by migrants.

A systematic review of the use of health services by immigrants and native populations

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.

Hospital admissions among immigrants from low-income and foreign citizens from high-income countries in Spain in 2000-2012

Over the last decade, the number of foreign nationals in Spain has increased. Our aim was to report the trends in hospital admissions, differentiating between foreign nationals from high-income countries (HICs) and from low- and middle-income countries (LMICs) in a public hospital. A retrospective analysis of hospital admissions in patients aged ⩾15 years between 2000 and 2012 was performed by means of hospital information systems at a public hospital in the city of Alicante, Spain. During the period of the study, 387,862 patients were admitted: 32,020 (8.3%) were foreign, 22,446 (5.8%) were from LMICs, and 9574 (2.5%) were from HICs. The number of foreign nationals, foreign nationals from LMICs, and foreign nationals from HICs admitted increased from 1019, 530, and 489 in 2000 to 2925, 2097, and 828, respectively in 2012. A total of 27.5% of patients were admitted for pregnancy, childbirth, and puerperium, especially foreign nationals from LMICs (34.3%), and 14.1% of foreign nationals were admitted for cardiovascular diseases (14.1%), which were more common in those from HICs (26.3%). The number of admissions among foreign nationals from LMICs increased significantly in all the diagnoses, but in pregnancy, childbirth, and puerperium, the increase was higher. In conclusion, nearly one out of 10 adult patients admitted to our hospital was foreign, mainly from LMICs, and the main reason for admission was diagnoses related to pregnancy, childbirth, and puerperium.

Register study of migrants' hospitalization in Norway: world region origin, reason for migration, and length of stay

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.

[Infectious diseases in the adult population admitted to a general hospital]

INTRODUCTION

To determine the infectious diseases (ID) that led to hospital admission of the foreign population>14 years.

MATERIAL AND METHODS

A retrospective study of foreign patients admitted to hospital (2000-2012).

RESULTS

A total of 3,087 foreigners were admitted with infectious diseases. Of these, 73.6% were from low income countries, and 26.4% from high income countries. Most of them (86.9%) were admitted with common ID, 11.8% with transmissible ID, and 1.6% with tropical ID. Tropical ID and transmissible ID were higher in patients from low income countries (14.7%) than from high income countries (9.7%, p<0.001). The main tropical ID was malaria (74%). The main transmissible ID were tuberculosis (40.3%), hepatitis (27.8%), and HIV/AIDS (27.5%).

CONCLUSION

Common ID were the main reason for admission in foreign population.