Barriers to Accessing Primary Care and Appropriateness of Healthcare Among Immigrants in Italy

Abstract

IntroductionThe health status and health care needs of immigrant populations must be assessed. The aim of this study was to evaluate barriers to accessing primary care and the appropriateness of health care among resident immigrants in Italy, using indicators regarding maternal health, avoidable hospitalization, and emergency care.MethodsCross-sectional study using some indicators of the National Monitoring System of Health Status and Healthcare of the Immigrant Population (MSHIP), coordinated by the National Institute for Health, Migration and Poverty (INMP), calculated on perinatal care, hospital discharge, and emergency department databases for the years 2016–2017 in nine Italian regions (Piedmont, Trento, Bolzano, Emilia-Romagna, Tuscany, Umbria, Latium, Basilicata, Sicily). The analyses were conducted comparing immigrant and Italian residents.ResultsCompared to Italian women, immigrant women had fewer than five gynecological examinations (8.5 vs. 16.3%), fewer first examinations after the 12th week of gestational age (3.8 vs. 12.5%), and fewer than two ultrasounds (1.0 vs. 3.8%). Compared to Italians, immigrants had higher standardized rates (× 1,000 residents) of avoidable hospitalizations (males: 2.1 vs. 1.4; females: 0.9 vs. 0.7) and of access to emergency departments for non-urgent conditions (males: 62.0 vs. 32.7; females: 52.9 vs. 31.4).ConclusionsIn Italy, there appear to be major issues regarding accessing services and care for the immigrant population. Policies aimed at improving socioeconomic conditions and promoting integration can promote healthy lifestyles and appropriate access to health care, counteracting the emergence of health inequities in the immigrant population.

The effect of diabetes on COVID-19 incidence and mortality: Differences between highly-developed-country and high-migratory-pressure-country populations

“…Both ethnicity and SES influence behaviors that can impact obesity [through diet and physical activity ( 33 , 34 )], vaccination ( 35 , 36 ) and—among individuals with diabetes—glycemic control ( 21 ) and access to health care ( 37 ). Furthermore, linguistic and logistical barriers limit the accessibility of health care for immigrants ( 37 , 38 ). Behaviors and living and working conditions influence the probability that an individual will be in contact with SARS-CoV-2 ( 5 , 6 , 39 ).…”

Healthcare (im)mobilities and the Covid-19 pandemic: Notes on returning to the field

“…Emergency Rooms, Accident and Emergency services). There is a strong argument for linking these differences with structural and cultural barriers to health: studies in Italy and the UK found that emergency care services were frequently the first (and sometimes only) contact migrants had with the national health system (Di Napoli et al, 2022; Harrison and Daker-White, 2019). This may in part be related to the fact that, for many origin countries, the hospital is the first (or only) point of access to the healthcare system, but it also speaks to these services’ greater flexibility and responsiveness.…”

“…This may in part be related to the fact that, for many origin countries, the hospital is the first (or only) point of access to the healthcare system, but it also speaks to these services’ greater flexibility and responsiveness. For example, emergency services are always in operation and many migrants work in precarious and complex employment conditions; they may need to access primary care outside regular business hours (Di Napoli et al, 2022: 5). It is also a resource that helps circumvent the complexity of navigating health systems by providing a prompt resolution of an immediate need while simultaneously reducing linguistic, cultural and bureaucratic barriers (De Luca et al, 2013).…”

Considerazioni chiave: equità e partecipazione nella promozione della vaccinazione per il covid-19 tra le persone razzializzate e senza documenti

“…30 Despite this, structural barriers persist, which deny undocumented persons access to routine and preventative treatment through the national healthcare system. 31 Without a National Insurance Number (associated with selected permits of stay or Italian citizenship), there are mechanisms through which undocumented persons can access care, though the issuance of a code -the Straniero temporaneamente presente (STP) (literally "temporary resident foreigner"). The STP code is obtained physically, at local health authorities.…”

“…Research shows that undocumented individuals face structural barriers in accessing public health services, 31,35 which have deeply affected their engagement with COVID-19 vaccination campaigns. This section outlines specific barriers which prevent uptake of vaccines among undocumented migrants living in Italy.…”