Primary health care utilization by immigrants as compared to the native population: a multilevel analysis of a large clinical database in Catalonia

Eur J Gen Pract. 2012 Jun;18(2):100-6. doi: 10.3109/13814788.2012.656085. Epub 2012 May 10.

Abstract

Background: Immigration is a relevant public health issue and there is a great deal of controversy surrounding its impact on health services utilization.

Objective: To determine differences between immigrants and non-immigrants in the utilization of primary health care services in Catalonia, Spain.

Methods: Population based, cross-sectional, multicentre study. We used the information from 16 primary health care centres in an area near Barcelona, Spain. We conducted a multilevel analysis for the year 2008 to compare primary health care services utilization between all immigrants aged 15 or more and a sample of non-immigrants, paired by age and sex.

Results: Overall, immigrants living in Spain used health services more than non-immigrants (Incidence Risk Ratio (IRR) 1.16 (95% Confidence Interval (CI): 1.15-1.16) and (IRR 1, 26, 95% CI: 1.25-1.28) for consultations with GPs and referrals to specialized care, respectively. People coming from the Maghreb and the rest of Africa requested the most consultations involving a GP and nurses (IRR 1.34, 95% CI: 1.33-1.36 and IRR 1.06, 95% CI: 1.03-1.44, respectively). They were more frequently referred to specialized care (IRR 1.44, 95% CI: 1.41-1.46) when compared to Spaniards. Immigrants from Asia had the lowest numbers of consultations with a GP and referrals (IRR 0.76, 95% CI: 0.66-0.88 and IRR 0.76, 95% CI: 0.61-0.95, respectively.

Conclusion: On average, immigrants living in Catalonia used the health services more than non-immigrants. Immigrants from the Maghreb and other African countries showed the highest and those from Asia the lowest, number of consultations and referrals to specialized care.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Databases, Factual
  • Emigrants and Immigrants / statistics & numerical data*
  • Female
  • General Practitioners / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care / statistics & numerical data*
  • Referral and Consultation / statistics & numerical data*
  • Spain
  • Specialization
  • Young Adult