Barriers to health care for undocumented immigrants: a literature review.
Barriers to health care for undocumented immigrants: a literature review.
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无证件移民的卫生保健障碍：文献综述。
DOI：
10.2147/rmhp.s70173
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发表时间：
2015
影响因子：
3.5
通讯作者：
Zallman L
中科院分区：
文献类型：
--
作者：
Hacker K;Anies M;Folb BL;Zallman L
随着近年来史无前例的国际移徙，限制医疗保健机会的政策变得普遍起来。非法移民的医疗保健障碍超出了政策范围，范围从经济限制到歧视和对驱逐出境的恐惧。本文旨在回顾有关非法移民医疗保健障碍的文献，并确定已经或可以用来解决这些障碍的战略。为了解决研究问题，我们对过去10年发表在PubMed上的文章进行了文献回顾，使用了三个主要概念：移民、无证和获得医疗保健。检索出341篇文章，其中66篇符合研究标准。关于障碍，我们确定了政策领域的障碍，重点是与法律和政策有关的问题，包括对获得和保健类型的限制。这些措施在不同国家之间差异很大，但最终影响了任何非法移民可以获得的医疗保健的类型和数量。在卫生系统内，障碍包括文书工作和登记制度等官僚障碍。可供选择的护理(安全网)普遍有限，不堪重负。最后，有证据表明，医疗保健系统本身存在广泛的歧视性做法。个人层面的重点是移民对驱逐出境的恐惧、耻辱和缺乏获得服务的资本(包括社会和财政)。审查的文件确定的建议包括倡导改变政策以增加无证移民获得医疗保健的机会，提供新的保险选择，扩大安全网服务，培训提供者更好地照顾移民人口，以及对无证移民进行系统导航方面的教育。非法移民的医疗保健面临着许多障碍。这些指标因国家而异，并经常发生变化。尽管人们担心获得医疗保健会吸引移民，但数据显示，人们通常不会移民来获得医疗保健。需要为非公民提供医疗保健的解决方案。
With the unprecedented international migration seen in recent years, policies that limit health care access have become prevalent. Barriers to health care for undocumented immigrants go beyond policy and range from financial limitations, to discrimination and fear of deportation. This paper is aimed at reviewing the literature on barriers to health care for undocumented immigrants and identifying strategies that have or could be used to address these barriers. To address study questions, we conducted a literature review of published articles from the last 10 years in PubMed using three main concepts: immigrants, undocumented, and access to health care. The search yielded 341 articles of which 66 met study criteria. With regard to barriers, we identified barriers in the policy arena focused on issues related to law and policy including limitations to access and type of health care. These varied widely across countries but ultimately impacted the type and amount of health care any undocumented immigrant could receive. Within the health system, barriers included bureaucratic obstacles including paperwork and registration systems. The alternative care available (safety net) was generally limited and overwhelmed. Finally, there was evidence of widespread discriminatory practices within the health care system itself. The individual level focused on the immigrant’s fear of deportation, stigma, and lack of capital (both social and financial) to obtain services. Recommendations identified in the papers reviewed included advocating for policy change to increase access to health care for undocumented immigrants, providing novel insurance options, expanding safety net services, training providers to better care for immigrant populations, and educating undocumented immigrants on navigating the system. There are numerous barriers to health care for undocumented immigrants. These vary by country and frequently change. Despite concerns that access to health care attracts immigrants, data demonstrates that people generally do not migrate to obtain health care. Solutions are needed that provide for noncitizens’ health care.