Impact on and use of health services by international migrants: questionnaire survey of inner city London A&E attenders.
Impact on and use of health services by international migrants: questionnaire survey of inner city London A&E attenders.
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DOI：
10.1186/1472-6963-6-153
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发表时间：
2006-11-29
影响因子：
2.8
通讯作者：
Holmes A
中科院分区：
文献类型：
--
作者：
Hargreaves S;Friedland JS;Gothard P;Saxena S;Millington H;Eliahoo J;Le Feuvre P;Holmes A
不断变化的移民趋势对英国的开放式医疗服务提出了新的挑战，有相当多的猜测认为，来自资源贫乏国家的移民给服务带来了不成比例的负担。需要数据来为向移民群体提供服务提供信息，并确保他们获得适当的保健。我们比较了移民群体和英国出生的患者的社会人口特征和影响，这些患者前往医院A&E/Walk-In中心就诊，并事先使用基于社区的全科医生（GP）服务。我们对伦敦市中心一家医院的急诊室/无预约中心的所有就诊患者进行了为期1个月的匿名问卷调查。有关国籍，移民身份，在英国的时间，注册和使用GP服务的问题。我们通过卡方检验和Fisher精确检验使用双向表比较组间差异。我们使用逻辑回归模型来量化解释变量和结果的关联。3262例患者中有1611例完成了调查（应答率49.4%）。720人（44.7%）在海外出生，代表87个国籍，其中532人（73.9%）是新移民到英国（≤10年）。与当地估计值相比，海外出生者的比例过高（44.7% vs 33.6%; p < 0.001;比例差异0.111 [95% CI 0.087-0.136]）。主要的移民身份是：工作许可证（24.4%），欧盟公民（21.5%），只有21名（1.3%）政治庇护寻求者/难民。178人（11%）报告来自产生毒品的国家（RGC），如索马里，他们不太可能说英语。与RGC相比，在调整年龄和性别后，澳大利亚人，新西兰人和南非人（ANS组; OR 0.28 [95% CI 0.11 - 0.71]; p = 0.008）和其他移民（OM）组，主要包括欧洲人（0.13 [0.06至0.30]; p = 0.000）的患者不太可能有全科医生登记，也不太可能事先与全科医生接触，但这并不影响各组获得医院服务的方式，也不影响获得护理的时间。最近抵达的移徙者是一个多样化和庞大的群体，其中来自移民产生国的移徙者和寻求庇护者只占少数。服务重组，以确保更好地获得社区为基础的全科医生和提供更适当的护理可能会减少他们对急性服务的影响。
Changing immigration trends pose new challenges for the UK's open access health service and there is considerable speculation that migrants from resource-poor countries place a disproportionate burden on services. Data are needed to inform provision of services to migrant groups and to ensure their access to appropriate health care. We compared sociodemographic characteristics and impact of migrant groups and UK-born patients presenting to a hospital A&E/Walk-In Centre and prior use of community-based General Practitioner (GP) services. We administered an anonymous questionnaire survey of all presenting patients at an A&E/Walk-In Centre at an inner-city London hospital during a 1 month period. Questions related to nationality, immigration status, time in the UK, registration and use of GP services. We compared differences between groups using two-way tables by Chi-Square and Fisher's exact test. We used logistic regression modelling to quantify associations of explanatory variables and outcomes. 1611 of 3262 patients completed the survey (response rate 49.4%). 720 (44.7%) were overseas born, representing 87 nationalities, of whom 532 (73.9%) were new migrants to the UK (≤10 years). Overseas born were over-represented in comparison to local estimates (44.7% vs 33.6%; p < 0.001; proportional difference 0.111 [95% CI 0.087–0.136]). Dominant immigration status' were: work permit (24.4%), EU citizens (21.5%), with only 21 (1.3%) political asylum seekers/refugees. 178 (11%) reported nationalities from refugee-generating countries (RGCs), eg, Somalia, who were less likely to speak English. Compared with RGCs, and after adjusting for age and sex, the Australians, New Zealanders, and South Africans (ANS group; OR 0.28 [95% CI 0.11 to 0.71]; p = 0.008) and the Other Migrant (OM) group comprising mainly Europeans (0.13 [0.06 to 0.30]; p = 0.000) were less likely to have GP registration and to have made prior contact with GPs, yet this did not affect mode of access to hospital services across groups nor delay access to care. Recently arrived migrants are a diverse and substantial group, of whom migrants from refugee-generating countries and asylum seekers comprise only a minority group. Service reorganisation to ensure improved access to community-based GPs and delivery of more appropriate care may lessen their impact on acute services.
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DOI：
10.1080/09540120310001634001
发表时间：
2004-01-01
影响因子：
1.7
作者：
Anderson, J;Doyal, L
通讯作者：
Doyal, L
影响因子：
--
作者：
JANKOWSKI, RF;MANDALIA, S
通讯作者：
MANDALIA, S
影响因子：
4.8
作者：
Warfa, Nasir;Bhui, Kamaldeep;Thornicroft, Graham
通讯作者：
Thornicroft, Graham
影响因子：
3.4
作者：
Norredam, M;Krasnik, A;Nielsen, AS
通讯作者：
Nielsen, AS
影响因子：
4.4
作者：
Norredam, Marie;Mygind, Anna;Krasnik, Allan
通讯作者：
Krasnik, Allan