Gynaecology Research Today is a free monthly online journal that collates and summarizes the latest research about Gynaecology, including details on pap smears, laparoscopy, ultrasound, hysteroscopy. | ||||||||
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Hospital emergency department utilisation rates among the immigrant population in Barcelona, Spain.Buron A, Cots F, Garcia O, Vall O, Castells X
ABSTRACT: BACKGROUND: The recent increase in the number of immigrants of Barcelona represents a challenge for the public healthcare system, the emergency room being the most used healthcare service by this group. However, utilisation rates in our environment have not been studied yet. We aim to compare the emergency department utilisation rates of the Spanish-born and foreign-born in a public hospital of Barcelona. METHODS: The study population included all adults residing in the area of study and visiting the emergency department of Hospital del Mar in 2004. The emergency care episodes were selected from the Emergency Department register, and the population figures from the Statistics Department of Barcelona. Emergency care episodes were classified into five large clinical categories. Adjusted rate ratios (RR) of utilisation of foreign-born vs. Spanish-born were assessed through negative binomial regression. RESULTS: The overall utilisation rate was 382 emergency contacts per 1,000 persons-years. The RR for foreign-born versus Spanish-born residents was 0.62 (95% CI: 0.52; 0.74%). The RR was also significantly below one in surgery (0.51, 95% CI: 0.42; 0.63), traumatology (0.47, 95% CI: 0.38; 0.59), medicine (0.48, 95% CI: 0.38; 0.59) and psychiatry (0.42, 95% CI: 0.18; 0.97). No differences were found in utilisation of gynaecology and minor emergencies. CONCLUSIONS: The overall lower utilisation rates obtained for foreign-born is consistent with previous studies and is probably due to the "healthy immigrant effect". Thus, population increase due to immigration does not translate directly into a corresponding increase in the number of emergency contacts. The lack of differences in minor and gynaecological emergencies supports the hypothesis that immigrants overcome certain barriers by using the emergency department as the route of access to health services. The issue of healthcare barriers should therefore be addressed, especially among immigrants. Published 4 March 2008 in BMC Health Serv Res, 8(1): 51.
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