Health Services Access Inequalities Between Native and Immigrant in a Southern European Region

Int J Health Serv. 2019 Jan;49(1):108-126. doi: 10.1177/0020731418809858. Epub 2018 Nov 2.

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.

Keywords: gender; health care disparities; health surveys; immigrants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Cross-Sectional Studies
  • Emergency Service, Hospital / statistics & numerical data
  • Emigrants and Immigrants*
  • Female
  • General Practice / statistics & numerical data
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Language
  • Male
  • Middle Aged
  • Sex Factors
  • Socioeconomic Factors
  • Spain
  • Specialization
  • Young Adult