Frecuentación de las consultas de medicina general y especializada por población inmigrante y autóctona: una revisión sistemática

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Abstract

Fundamentos: España pasó a ser en 2006 el país europeo con mayor saldo migratorio. Un aspecto poco estudiado es el acceso y utilización de los servicios sanitarios de esta población. El objetivo de este estudio fue describir la evidencia científica sobre si existen diferencias en la utilización de los servicios de medicina general y especializada entre la población inmigrante con respecto a la autóctona. Métodos: Revisión sistemática. Se llevó a cabo una búsqueda de la literatura científica nacional e internacional de estudios que comparaban la utilización de los servicios de medicina general y especializada entre inmigrantes y autóctonos desde 1994 hasta 2013. Se utilizó para ello la base de datos MEDLINE además de una búsqueda manual, sin límite de lengua ni tipo de estudio. Se evaluó la calidad metodológica de los 29 trabajos finalmente incluidos. Se recopilaron características de los sujetos, del contexto, metodológicas y extrínsecas para comparar los estudios incluidos. Resultados: Se seleccionaron 29 estudios relativos a consulta de medicina general (9 realizados en España) y 15 sobre consulta a especialistas (7 de España) los cuales utilizan principalmente las encuestas de salud como fuente de información. Analizaron tanto la frecuentación como el contacto con el médico general y/o especialista según la nacionalidad o el país de nacimiento (entre otros), ajustando en su mayoría por variables de necesidad y/o socioeconómica. Conclusiones: En líneas generales, en España la población inmigrante hace el mismo uso de los servicios de medicina general que la autóctona y un menor o igual uso de los servicios de medicina especializada. Los resultados de los estudios realizados en otros países van en la misma línea.

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Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey.

Karen Lasser, David Himmelstein, Steffie Woolhandler (2006)

We compared health status, access to care, and utilization of medical services in the United States and Canada and compared disparities according to race, income, and immigrant status. We analyzed population-based data on 3505 Canadian and 5183 US adults from the Joint Canada/US Survey of Health. Controlling for gender, age, income, race, and immigrant status, we used logistic regression to analyze country as a predictor of access to care, quality of care, and satisfaction with care and as a predictor of disparities in these measures. In multivariate analyses, US respondents (compared with Canadians) were less likely to have a regular doctor, more likely to have unmet health needs, and more likely to forgo needed medicines. Disparities on the basis of race, income, and immigrant status were present in both countries but were more extreme in the United States. United States residents are less able to access care than are Canadians. Universal coverage appears to reduce most disparities in access to care.

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Reported health, lifestyles, and use of health care of first generation immigrants in The Netherlands: do socioeconomic factors explain their adverse position?

Sijmen A. Reijneveld (1998)

Differences in health, lifestyles, and use of health care between groups of varying ethnic origin can have important implications for preventive and curative health care. This paper studies whether socioeconomic factors explain ethnic differences in these outcomes. Data on health status, lifestyles, and use of health care were obtained from interviews with 3296 people aged 16-64 years (response: 60.6%), among whom were 848 first generation immigrants. Ethnic differences in these outcomes were examined with and without adjustment for socioeconomic factors, using logistic regression. General population of Amsterdam, the Netherlands. Health status (self rated health, General Health Questionnaire, functional limitations), lifestyles (smoking, alcohol), and use of health care (general practice, pharmaceuticals, hospitalisations). Immigrants from Turkey, Morocco and (former) Dutch colonies report a poorer health and a higher use of health care, especially primary health care among the elderly. An adverse socioeconomic position partially explains the poor health of these immigrants. In turn, their poor health explains most of their higher use of health care. Cultural factors and poor living conditions seem to contribute to the poor health of immigrants, besides an adverse socioeconomic position. The pressure on various health services will increase in future because of the relatively high increase in immigrants' needs at older ages and their presently low mean age.

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Health care utilization, family context, and adaptation among immigrants to the United States.

F LeClere, Randy Jensen, A E Biddlecom (1994)

We use the 1990 National Health Interview Survey supplement on Family Resources to examine the health care utilization patterns of immigrant and native-born adults in the United States. We modify a standard health care utilization framework by including duration of residence in the United States and measures of immigrant adaptation and family health context to model both the probability and number of physician contacts in the previous year. We find that duration of residence has a strong effect. Recently-arrived immigrants are much less likely to have had a contact in the previous year and had fewer contacts than either native-born or longer-term immigrant adults. Once the measures of adaptation--age at immigration and language of survey interview--are included, immigrants who have been in the United States for 10 years or more are not statistically different from the native-born. Family characteristics, including measures of exposure to the formal health care system, slightly reduce the size of the effects but do not alter the basic relationship between duration of residence and health care utilization. These results suggest that, net of socioeconomic characteristics, access to health insurance, and differences in morbidity, recent immigrants are much less likely than both the native-born and those immigrants of longer duration, to receive timely health care.

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SciELO Spain ID:: S1135-57272014000100009

DOI:: 10.4321/s1135-57272014000100009

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http://creativecommons.org/licenses/by/4.0/

ScienceOpen disciplines: Public health

Keywords: Systematic review,Emigrants and Immigrants,Health Services Accessibility,Revisión sistemática,Emigrantes e inmigrantes,Accesibilidad a los Servicios de Salud

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ScienceOpen disciplines: Public health

Keywords: Systematic review, Emigrants and Immigrants, Health Services Accessibility, Revisión sistemática, Emigrantes e inmigrantes, Accesibilidad a los Servicios de Salud

Frecuentación de las consultas de medicina general y especializada por población inmigrante y autóctona: una revisión sistemática

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Most cited references 162

Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey.

Reported health, lifestyles, and use of health care of first generation immigrants in The Netherlands: do socioeconomic factors explain their adverse position?

Health care utilization, family context, and adaptation among immigrants to the United States.

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