Register study of migrants’ hospitalization in Norway: world region origin, reason for migration, and length of stay

Abstract

BackgroundThe proportion of migrants and refugees increase in many populations. Health planners have to consider how migration will influence demand for health care. This study explores how migrants’ geographical origin, reason for migration, and duration of residence are associated with admission rates to somatic hospitals in Norway.MethodsSociodemographic information on all individuals residing in Norway at the start of 2008 was linked to data on all admissions to somatic hospitals during 2008–2011. Migrants, age 30–69, who had come to Norway during 1970–2007 (N = 217,907), were classified into seven world region origins and compared with native Norwegians of the same age (N = 2,181,948). Any somatic hospital stay 2008–2011 and number of hospital admissions 2008–2011 per 1000 personyears for a set of somatic diagnoses were analyzed by age and gender standardized rates, linear probability models, and Poisson regression.ResultsIn the native Norwegian sample, 28.7 % had at least one admission 2008–2011, and there were 116 admissions per 1000 personyears. Corresponding age and gender adjusted figures for the migrant sample were 27.0 % and 103 admissions. Admission rates varied with migrants’ geographical origin, with relatively many admissions among migrants from West and South Asia and relatively few admissions among migrants from Western, East European, and Other Asian countries. Hospitalization varied strongly with reason for migration, with low admission rates for recent work migrants and high admission rates for recent refugees. Admission rates tended to move towards the level among native Norwegians with increasing length of stay. Among longstanding migrants (arrival period 1970–1989), admission rates were close to the levels of native Norwegians for most analyzed migrant categories.ConclusionBoth world region origin, reason for migration, and duration of residence are important sources for variations in migrants’ utilization of somatic hospitals. Forecasts about migrants’ use of hospital services have to take into account how the migrant population is composed as to these three determinants. High admission rates among recently arrived refugees should be a health policy concern.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1561-9) contains supplementary material, which is available to authorized users.

4. Migrants’ Consumption of Healthcare Services in Norway: Inclusionary and Exclusionary Structures and Practices

“…It is therefore important to include information about migrants' access to preventive health services. For example, a study among Somali women in Norway shows that despite the women's good knowledge of diabetes and risk factors such as sedentary lifestyle and unhealthy diet, they faced barriers to being physically active, such as time pressure, a lack of financial affordability for training facilities, and an absence of a tailored physical activity environment, such as training facilities not being gender-exclusive (Gele, Torheim, Pettersen, & Kumar, 2015). A similar study on barriers to outdoor physical activity among Somali youth, pointed out financial barriers such as expensive outdoor clothing, lack of time because of parents' work and children having afterschool jobs (Rothe et al, 2010).…”

“…According to Debesay, Harsløf, Rechel, and Vike (2014) the healthcare policies implemented to tackle challenges stemming from migration often fail to keep pace with social change because the structural dimension of everyday experience is not recognized. Moreover, according to Elstad (2016), the world region origin, reason for migration and duration of residence are important sources for variations in migrants' utilization of healthcare services. Solé-Auró et al (2012) suggest that the observed differences on migrants' access to and use of healthcare across countries requires further exploration of the cultural, political and financial features affecting the propensity for use of healthcare consumption.…”

“…Knowing more about the factors that influence migrants' use of health care services can help aid health care delivery and policy planning. In view of the increasing proportion of migrants and refugees, health planners need to consider how migration influences demand for health care services (Elstad, 2016).…”

Differences in ill health and in socioeconomic inequalities in health by ethnic groups: a cross-sectional study using 2011 Scottish census

“…The healthy migrant effect can also explain why some minority groups have lower levels of poor health and low socioeconomic inequalities in health, particularly for younger working age adults (Elstad 2016;Khan et al 2017). We know most of the young minority population (aged 15-44) in Scotland to be recent migrants and thus the results for working age White Polish and Chinese are in line with this theory.…”

Analysis of Prehospital Care of Migrants Who Arrive Intermittently at the Coasts of Southern Spain

“…There are more studies that describe the hospital care of immigrants residing in Spain [36][37][38] in a more extensive way, but these do not address the healthcare needs when the boats arrive. In the same way, other studies address these same issues related to hospital care or access to specific services offered by different health systems in the context of other countries, analyzing their barriers and difficulties [39][40][41][42]. These studies emphasize that the attention needed by these populations are not limited to those presented at the time of their arrival, but, sometimes, the approach to the problems that appear later are much more complex.…”