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. 2011 Jun 6:11:432.
doi: 10.1186/1471-2458-11-432.

Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

Amaia Calderón-Larrañaga  1 , Luis A Gimeno-Feliu, Rosa Macipe-Costa, Beatriz Poblador-Plou, Daniel Bordonaba-Bosque, Alexandra Prados-Torres
Affiliations

Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

Amaia Calderón-Larrañaga et al. BMC Public Health. .

Abstract

Background: There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden.

Methods: This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System®).

Results: The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix.

Conclusions: Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain.

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Figures

Figure 1
Figure 1
Mean Resource Utilisation Band scores in immigrant and native populations by age band and sex.
Figure 2
Figure 2
Age- and sex-adjusted mean Resource Utilisation Band scores in adults and children by nationality.
See this image and copyright information in PMC

References

    1. Berra S, Elorza-Ricart JM. Salud y uso de servicios en los sistemas sanitarios en población autóctona e inmigrante de España. Madrid: Plan de Calidad para el Sistema Nacional de Salud. Ministerio de Ciencia e Innovación. Agència d'Avaluació de Tecnologia i Recerca Mèdiques de Cataluña; 2009. Informes de Evaluación de Tecnologías Sanitarias, AATRM Núm. 2007/2008. 2009.
    1. Pitkin Derose K, Bahney BW, Lurie N, Escarce JJ. Review: immigrants and health care access, quality, and cost. Med Care Res Rev. 2009;66(4):355–408. doi: 10.1177/1077558708330425. - DOI - PubMed
    1. Fuertes C, Martin Laso M. El inmigrante en la consulta de atencion primaria. An Sist Sanit Navar. 2006;29(Suppl 1):9–25. - PubMed
    1. McDonald JT, Kennedy S. Insights into the 'healthy immigrant effect': health status and health service use of immigrants to Canada. Soc Sci Med. 2004;59(8):1613–1627. doi: 10.1016/j.socscimed.2004.02.004. - DOI - PubMed
    1. Starfield B. Threads and yarns: weaving the tapestry of comorbidity. Ann Fam Med. 2006;4(2):101–103. doi: 10.1370/afm.524. - DOI - PMC - PubMed

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