Impact of immigration on the cost of emergency visits in Barcelona (Spain)

Background: The impact of immigration on health services utilisation has been analysed by several studies performed in countries with lower levels of immigration than Spain. These studies indicate that health services utilisation is lower among the immigrant population than among the host population...

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Autores: Cots, Francesc, Castells, Xavier, García, Óscar, Riu Camps, Marta, Felipe, Aida, Vall, Oriol
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2007
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/69089
Acceso en línea:http://hdl.handle.net/10230/69089
http://dx.doi.org/10.1186/1472-6963-7-9
Access Level:acceso abierto
Palabra clave:Emergency department
Variable cost
Immigrant woman
Emergency service
Immigrant population
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spelling Impact of immigration on the cost of emergency visits in Barcelona (Spain)Cots, FrancescCastells, XavierGarcía, ÓscarRiu Camps, MartaFelipe, AidaVall, OriolEmergency departmentVariable costImmigrant womanEmergency serviceImmigrant populationBackground: The impact of immigration on health services utilisation has been analysed by several studies performed in countries with lower levels of immigration than Spain. These studies indicate that health services utilisation is lower among the immigrant population than among the host population and that immigrants tend to use hospital emergency services at the expense of primary care. We aimed to quantify the relative over-utilisation of emergency services in the immigrant population. Methods: Emergency visits to Hospital del Mar in Barcelona in 2002 and 2003 were analysed. The country of origin, gender, age, discharge-related circumstances (hospital admission, discharge to home, or death), medical specialty, and variable cost related to medical care were registered. Immigrants were grouped into those from high-income countries (IHIC) and those from low-income countries (ILIC) and the average direct cost was compared by country of origin. A multivariate linear mixed model of direct costs was adjusted by country of origin (classified in five groups) and by the individual variables of age, gender, hospital admission, and death as a cause of discharge. Medical specialty was considered as a random effect. Results: With the exception of gynaecological emergency visits, costs resulting from emergency visits by both groups of immigrants were lower than those due to visits by the Spanish-born population. This effect was especially marked for emergency visits by adults. Conclusion: Immigrants tend to use the emergency department in preference to other health services. No differences were found between IHIC and ILIC, suggesting that this result was due to the ease of access to emergency services and to lack of knowledge about the country's health system rather than to poor health status resulting from immigrants' socioeconomic position. The use of costs as a variable of complexity represents an opportunistic use of a highly exhaustive registry, which is becoming ever more frequent in hospitals and which overcomes the lack of clinical information related to outpatient activity.BioMed Central202520252007info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/69089http://dx.doi.org/10.1186/1472-6963-7-9reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésBMC Health Serv Res. 2007 Jan 19;7:9© 2007 Cots et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.http://creativecommons.org/licenses/by/2.0info:eu-repo/semantics/openAccessoai:recercat.cat:10230/690892026-05-29T05:05:01Z
dc.title.none.fl_str_mv Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title Impact of immigration on the cost of emergency visits in Barcelona (Spain)
spellingShingle Impact of immigration on the cost of emergency visits in Barcelona (Spain)
Cots, Francesc
Emergency department
Variable cost
Immigrant woman
Emergency service
Immigrant population
title_short Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title_full Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title_fullStr Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title_full_unstemmed Impact of immigration on the cost of emergency visits in Barcelona (Spain)
title_sort Impact of immigration on the cost of emergency visits in Barcelona (Spain)
dc.creator.none.fl_str_mv Cots, Francesc
Castells, Xavier
García, Óscar
Riu Camps, Marta
Felipe, Aida
Vall, Oriol
author Cots, Francesc
author_facet Cots, Francesc
Castells, Xavier
García, Óscar
Riu Camps, Marta
Felipe, Aida
Vall, Oriol
author_role author
author2 Castells, Xavier
García, Óscar
Riu Camps, Marta
Felipe, Aida
Vall, Oriol
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Emergency department
Variable cost
Immigrant woman
Emergency service
Immigrant population
topic Emergency department
Variable cost
Immigrant woman
Emergency service
Immigrant population
description Background: The impact of immigration on health services utilisation has been analysed by several studies performed in countries with lower levels of immigration than Spain. These studies indicate that health services utilisation is lower among the immigrant population than among the host population and that immigrants tend to use hospital emergency services at the expense of primary care. We aimed to quantify the relative over-utilisation of emergency services in the immigrant population. Methods: Emergency visits to Hospital del Mar in Barcelona in 2002 and 2003 were analysed. The country of origin, gender, age, discharge-related circumstances (hospital admission, discharge to home, or death), medical specialty, and variable cost related to medical care were registered. Immigrants were grouped into those from high-income countries (IHIC) and those from low-income countries (ILIC) and the average direct cost was compared by country of origin. A multivariate linear mixed model of direct costs was adjusted by country of origin (classified in five groups) and by the individual variables of age, gender, hospital admission, and death as a cause of discharge. Medical specialty was considered as a random effect. Results: With the exception of gynaecological emergency visits, costs resulting from emergency visits by both groups of immigrants were lower than those due to visits by the Spanish-born population. This effect was especially marked for emergency visits by adults. Conclusion: Immigrants tend to use the emergency department in preference to other health services. No differences were found between IHIC and ILIC, suggesting that this result was due to the ease of access to emergency services and to lack of knowledge about the country's health system rather than to poor health status resulting from immigrants' socioeconomic position. The use of costs as a variable of complexity represents an opportunistic use of a highly exhaustive registry, which is becoming ever more frequent in hospitals and which overcomes the lack of clinical information related to outpatient activity.
publishDate 2007
dc.date.none.fl_str_mv 2007
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/69089
http://dx.doi.org/10.1186/1472-6963-7-9
url http://hdl.handle.net/10230/69089
http://dx.doi.org/10.1186/1472-6963-7-9
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv BMC Health Serv Res. 2007 Jan 19;7:9
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/2.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/2.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
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