Use of Health Services and Unmet Need among Adults of Russian, Somali, and Kurdish Origin in Finland (original) (raw)
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BMC Health Services Research
Background Many European studies have shown migrants to be less satisfied with health care and find it less accessible than the general populations. The aim of this study was to compare satisfaction with access to health care between migrants from different regions of origin and the general population of Finland. Methods This study uses data from two comprehensive survey samples on health and wellbeing of the foreign-born and the general population living in Finland. Three aspects of satisfaction with health care access were measured and predicted by region of origin using logistic regression. Results Foreign-born population was slightly more dissatisfied with all aspects of the access to health care as compared to the general population. In all aspects of access, migrants from the Middle East and Africa were least likely to be satisfied. Conclusions As the satisfaction with access was lowest among migrant groups which are likely to have higher needs for at least some health service...
International Journal of Environmental Research and Public Health
Mounting evidence suggests that migration background increases the risk of mental ill health, but that problems exist in accessing healthcare services in people of migrant origin. The present study uses a combination of register- and survey-based data to examine mental health-related health service use in three migrant origin populations as well as the correspondence between the need and use of services. The data are from the Finnish Migrant Health and Wellbeing Study (Maamu), a comprehensive cross-sectional interview and a health examination survey. A random sample consisted of 5909 working-aged adults of Russian, Somali, and Kurdish origin of which 3000 were invited to participate in the survey and the rest were drawn for a register-based approach. Some of the mental health services, based on registers, were more prevalent in the Kurdish origin group in comparison with the general population and less prevalent in the Russian and Somali origin groups. All the migrant origin groups ...
BMC Public Health, 2008
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Determinants of Health Care Services Utilization among First Generation Afghan Migrants in Istanbul
International journal of environmental research and public health, 2017
There is insufficient empirical evidence on the correlates of health care utilization of irregular migrants currently living in Turkey. The aim of this study was to identify individual level determinants associated with health service and medication use. One hundred and fifty-five Afghans completed surveys assessing service utilization including encounters with primary care physicians and outpatient specialists in addition to the use of prescription and nonprescription medicines. Multivariate logistic regression analyses were employed to examine associations between service use and a range of predisposing, enabling, and perceived need factors. Health services utilization was lowest for outpatient specialists (20%) and highest for nonprescription medications (37%). Female gender and higher income predicted encounters with primary care physicians. Income, and other enabling factors such as family presence in Turkey predicted encounters with outpatient specialists. Perceived illness-re...
Immigrants’ use of emergency primary health care in Norway: a registry-based observational study
BMC Health Services Research, 2012
Background: Emigrants are often a selected sample and in good health, but migration can have deleterious effects on health. Many immigrant groups report poor health and increased use of health services, and it is often claimed that they tend to use emergency primary health care (EPHC) services for non-urgent purposes. The aim of the present study was to analyse immigrants' use of EPHC, and to analyse variations according to country of origin, reason for immigration, and length of stay in Norway. Methods: We conducted a registry based study of all immigrants to Norway, and a subsample of immigrants from Poland, Germany, Iraq and Somalia, and compared them with native Norwegians. The material comprised all electronic compensation claims for EPHC in Norway during 2008. We calculated total contact rates, contact rates for selected diagnostic groups and for services given during consultations. Adjustments for a series of sociodemographic and socio-economic variables were done by multiple logistic regression analyses. Results: Immigrants as a whole had a lower contact rate than native Norwegians (23.7% versus 27.4%). Total contact rates for Polish and German immigrants (mostly work immigrants) were 11.9% and 7.0%, but for Somalis and Iraqis (mostly asylum seekers) 31.8% and 33.6%. Half of all contacts for Somalis and Iraqis were for non-specific pain, and they had relatively more of their contacts during night than other groups. Immigrants' rates of psychiatric diagnoses were low, but increased with length of stay in Norway. Work immigrants suffered less from respiratory and gastrointestinal infections, but had more injuries and higher need for sickness certification. All immigrant groups, except Germans, were more often given a sickness certificate than native Norwegians. Use of interpreter was reduced with increasing length of stay. All immigrant groups had an increased need for long consultations, while laboratory tests were most often used for Somalis and Iraqis. Conclusions: Immigrants use EPHC services less than native Norwegians, but there are large variations among immigrant groups. Work immigrants from Germany and Poland use EPHC considerably less, while asylum seekers from Somalia and Iraq use these services more than native Norwegians.
Migrants’ access to healthcare services: evidence from fieldwork in Turkey
New Perspectives on Turkey, 2023
This study builds on an analytical framework of access to healthcare and, using notes from interviews conducted with 110 migrants of different categories, it discusses the fit between migrant patients and Turkish health services. There is an overall mediocre fit between migrant patients and the Turkish healthcare system, which varies for different migrant groups, and is influenced by the dimensions of awareness, availability, affordability, and accommodation. Migrants’ social capital and socio economic statuses affect the degree of fit, while irregularities in their legal statuses do not necessarily create a misfit. The existence of many private healthcare institutions offering various services to patients with different incomes and operating in informal ways has improved accessibility, availability, affordability, and accommodation and thus affects the fit positively. Therefore, the health reforms that paved the way for privatization, marketization, and commodification of health services in Turkey in the early 2000s also help explain the degree of fit. Migrants suffer most from language barriers in the health system, and there is an alarming decline in acceptability especially for Syrian refugees, who have reported facing discrimination while seeking healthcare.
BMC Health Services Research, 2021
Background Understanding the differential utilization of healthcare services is essential to address the public health challenges. Through the migration process, refugees move from one set of health risk factors to another and can face multiple healthcare challenges along their journey. Yet how these changing risk factors influence refugees’ use of health care services is poorly understood. Methods A longitudinal survey assessing health care utilization of 353 adult Syrian refugees was conducted; first in a transit setting in Lebanon and after one year of resettlement in Norway. The main outcomes are the utilization of general practitioner services, emergency care, outpatient and/or specialist care and hospitalization during the previous 12 months. Associations between use of healthcare services and several sociodemographic, migration-related and health status variables at both time points were found using regression analysis. We also analyzed longitudinal changes in utilization rat...
Quality and equality of access to healthcare services : HealthQUEST country report for Finland
2008
This is the Finnish country report for the European HealthQUEST project, which aimed to assess access to health care in eight EU Member States, with special emphasis on three vulnerable groups at risk of social exclusion: migrants, frail elderly and people with mental disorders. The project was commissioned in 2007 by the European Commission Directorate General for Employment, Social Affairs and Equal Opportunities and coordinated by the European Health Management Association (EHMA). The country report was undertaken by analysis of relevant literature, policy documents and legislation as well as interviews with experts and user representatives. In general, the Finnish health care system supports equity targets but closer consideration points out some unfair structural features of the system. It is guaranteed in the Constitution that all residents in Finland have the right to adequate social, health and medical services. A major reason for inequity in access to care is the existence of three different pathways to health care in Finland: municipal health care, private health care and occupational health care. Municipal health care is the main service producer, although private and occupational health services have grown substantially, which has undermined the equity principle of Finnish health care. In municipal health care, increased user fees create a potential barrier of access for poor people. Research indicates that there is geographical inequality, i.e. regional differences in the provision of health services, as well as socioeconomic differences in the content, quality and outcomes of in-patient care. The policy to use payment ceilings for user fees in public health care, medication spending and transportation to health care offers some support for access to health care, but the payment limits are probably insufficient for those worst off. Policy actions which have improved access to health care include the introduction of maximum waiting times for public sector health care and the extension of public dental care to all age groups. The horizontal policy of establishing inter-service labour force service centres as well as health checks for unemployed people may be of special importance for vulnerable groups like people with mental disorders. Migration is a relatively new phenomenon in Finland, which is reflected in the small number of health services research focusing on migrants. Culturally sensitive care forms a challenge for health services in Finland. In principle, migrants and minority groups have equal access to health care, but migrants not being registered residents have restricted access. The amount of migrants using the health care system is set to increase thus placing new responsiveness demands on health care delivery. Health and social services for older people have been directed from inpatient to outpatient services. The equality of older people in access to health services is being improved by developing a more extensive and harmonised assessment of service needs. Everyone over 80 years of age should have an assessment by a team of health and social care professionals for their non-emergency service needs within seven days. Problems exist in meeting the needs of older people in allocation of care and services, especially concerning the treatment of sleep disorders, depression, pain, fall prevention, and dementia. Fragmentation of services constitutes a barrier of access for older people and therefore reforms to integrate of health care and social services are crucial.