The role of acculturation in migrants’ use of gynecologic emergency departments

Abstract

Objective To examine whether acculturation of migrant patients is a predictor of non‐urgent use of gynecologic emergency departments (GEDs). Methods A cross‐sectional study based on standardized questionnaire interviews among migrant (n=477) and non‐migrant (n=246) women attending a GED in Berlin, Germany, between 2017 and 2018. Non‐urgent GED use was defined by health system (e.g., no hospital admission) or patient (e.g., low subjective urgency) criteria. Acculturation was assessed by the Frankfurt Acculturation Scale. Logistic regressions were calculated with non‐migrants as the reference. Results Relative to migrants, low acculturation of migrants had no significant effect on overall non‐urgent GED use. However, low acculturation was a significant predictor of non‐urgent use if defined only by health system criteria (adjusted odds ratio [AOR], 1.58; 95% confidence interval [CI], 1.02–2.44; P=0.041). Inversely, low acculturation had a significant negative effect on non‐urgent use if defined only by patient criteria (AOR, 0.58; 95% CI, 0.38–0.90; P=0.014). Conclusion Low‐acculturated migrants were more prone to non‐urgent GED use as defined by health system criteria, and might have a distorted perception of urgency. According to their perception, however, low‐acculturated patients showed appropriate GED use for urgent complaints, indicating that they are insufficiently cared for by the healthcare system.

Adequate Utilization of Emergency Services in Germany: Is There a Differential by Migration Background?

“…Only visiting a gynecology emergency clinic compared to internal medicine did modify the size of the association between migration status and adequacy. More detailed results for patients in the present study who visited the gynecology hospital-based outpatient clinic are reported in (19). The observed rate of admission to hospital (40%) was in line with what has been reported elsewhere (6).…”

Health literacy in Germany

“…Obwohl die Schlussfolgerungen zum Teil auf einer sehr kleinen Anzahl von Studien beruhen, stellen sie insbesondere bei Personen mit eigener Migrationserfahrung eine geringere Nutzung von Fachärzten und Präventionsprogrammen fest.22 Bezüglich der Inanspruchnahme von Allgemeinmedizinern, Krankenhausaufenthalten, Notfalldiensten und Impfungen liegen inkonsistente Ergebnisse vor. Die Ergebnisse von zwei neueren Studien aus Deutschland weisen jedoch auf eine höhere, als nicht notwendig eingeschätzte23 Nutzung der Notaufnahmeabteilungen in Krankenhäusern durch Personen mit Migrationshintergrund hin(Schwachenwalde et al 2020, Scherer et al 2017. In erstgenannter Studie kommen die Forschenden zu dem Schluss, dass diese inadäquate Nutzung möglicherweise auf fehlendes Wissen über Alternativen zur Notversorgung zurückzuführen ist.…”

Addressing disparities and challenges in underserved patient populations with metastatic breast cancer in Europe

“…However, it also showed that the prevalence of breast screening is higher among immigrant women in Northern Italy than among Italian women in Southern Italy [ 64 ]. In general, migrant women are more likely to utilize emergency health services than non-migrants [ 65 ], which is likely related to low rates of acculturation [ 66 ]. Lack of awareness and misrepresentation may also affect the lesbian, gay, bisexual and transgender community and there is a need for improved appropriate social support for sexual and gender minority BC survivors [ 67 ].…”