期刊论文详细信息
BMC Emergency Medicine
Use of emergency care services by immigrants—a survey of walk-in patients who attended the Oslo Accident and Emergency Outpatient Clinic
Per Hjortdahl1  Bård Natvig1  Ruth Aga2  Sven Eirik Ruud3 
[1] Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway;Section for Orthopaedic Emergency, Oslo University Hospital, Oslo, Norway;Department of Emergency General Practice, City of Oslo Health Agency, Oslo, Norway
关键词: Regular general practitioner;    Primary health care;    Health-seeking behaviour;    General practice;    Immigrant;    Emergency care utilization;   
Others  :  1230995
DOI  :  10.1186/s12873-015-0055-0
 received in 2014-12-15, accepted in 2015-10-05,  发布年份 2015
PDF
【 摘 要 】

Background

The Oslo Accident and Emergency Outpatient Clinic (OAEOC) experienced a 5–6 % annual increase in patient visits between 2005 and 2011, which was significantly higher than the 2–3 % annual increase among registered Oslo residents. This study explored immigrant walk-in patients’ use of both the general emergency and trauma clinics of the OAEOC and their concomitant use of regular general practitioners (RGPs) in Oslo.

Methods

A cross-sectional survey of walk-in patients attending the OAEOC during 2 weeks in September 2009. We analysed demographic data, patients’ self-reported affiliation with the RGP scheme, self-reported number of OAEOC and RGP consultations during the preceding 12 months. The first approach used Poisson regression models to study visit frequency. The second approach compared the proportions of first- and second-generation immigrants and those from the four most frequently represented countries (Sweden, Pakistan, Somalia and Poland) among the patient population, with their respective proportions within the general Oslo population.

Results

The analysis included 3864 patients: 1821 attended the Department of Emergency General Practice (“general emergency clinic”); 2043 attended the Section for Orthopaedic Emergency (“trauma clinic”). Both first- and second-generation immigrants reported a significantly higher OAEOC visit frequency compared with Norwegians. Norwegians, representing 73 % of the city population accounted for 65 % of OAEOC visits. In contrast, first- and second-generation immigrants made up 27 % of the city population but accounted for 35 % of OAEOC visits. This proportional increase in use was primarily observed in the general emergency clinic (42 % of visits). Their proportional use of the trauma clinic (29 %) was similar to their proportion in the city. Among first-generation immigrants only 71 % were affiliated with the RGP system, in contrast to 96 % of Norwegians. Similar finding were obtained when immigrants were grouped by nationality. Compared to Norwegians, immigrants from Sweden, Pakistan and Somalia reported using the OAEOC significantly more often. Immigrants from Sweden, Poland and Somalia were over-represented at both clinics. The least frequent RGP affiliation was among immigrants from Sweden (32 %) and Poland (65 %).

Conclusions

In Norway, immigrant subgroups use emergency health care services in different ways. Understanding these patterns of health-seeking behaviour may be important when designing emergency health services.

【 授权许可】

   
2015 Ruud et al.

【 预 览 】
附件列表
Files Size Format View
20151109012408481.pdf 811KB PDF download
Fig. 3. 31KB Image download
Fig. 2. 93KB Image download
Fig. 1. 44KB Image download
【 图 表 】

Fig. 1.

Fig. 2.

Fig. 3.

【 参考文献 】
  • [1]Statistikkbanken [Statistics Norway. StatBank Norway]. 2014. https://www.ssb.no/statistikkbanken/. Accessed 10 November 2014.
  • [2]Norredam M, Mygind A, Nielsen AS, Bagger J, Krasnik A. Motivation and relevance of emergency room visits among immigrants and patients of Danish origin. Eur J Public Health. 2007; 17:497-502.
  • [3]Petersen LA, Burstin HR, O’Neil AC, Orav EJ, Brennan TA. Nonurgent emergency department visits: the effect of having a regular doctor. Med Care. 1998; 36:1249-55.
  • [4]Rue M, Cabre X, Soler-Gonzalez J, Bosch A, Almirall M, Serna MC. Emergency hospital services utilization in Lleida (Spain): a cross-sectional study of immigrant and Spanish-born populations. BMC Health Serv Res. 2008; 8:81. BioMed Central Full Text
  • [5]Smaland Goth UG, Berg JE. Migrant participation in Norwegian health care. A qualitative study using key informants. Eur J Gen Pract. 2011; 17:28-33.
  • [6]Sandvik H, Hunskaar S, Diaz E. Immigrants’ use of emergency primary health care in Norway: a registry-based observational study. BMC Health Serv Res. 2012; 12:308. BioMed Central Full Text
  • [7]Buron A, Cots F, Garcia O, Vall O, Castells X. Hospital emergency department utilisation rates among the immigrant population in Barcelona, Spain. BMC Health Serv Res. 2008; 8:51. BioMed Central Full Text
  • [8]De Luca G, Ponzo M, Andres AR. Health care utilization by immigrants in Italy. Int J Health Care Finance Econ. 2013; 13:1-31.
  • [9]Dyhr L, Andersen JS, Engholm G. The pattern of contact with general practice and casualty departments of immigrants and non-immigrants in Copenhagen, Denmark. Dan Med Bull. 2007; 54:226-9.
  • [10]Hargreaves S, Friedland JS, Gothard P, Saxena S, Millington H, Eliahoo J et al.. Impact on and use of health services by international migrants: questionnaire survey of inner city London A&E attenders. BMC Health Serv Res. 2006; 6:153. BioMed Central Full Text
  • [11]Hjern A, Haglund B, Persson G, Rosen M. Is there equity in access to health services for ethnic minorities in Sweden? Eur J Public Health. 2001; 11:147-52.
  • [12]Norredam M, Krasnik A, Moller Sorensen T, Keiding N, Joost Michaelsen J, Sonne NA. Emergency room utilization in Copenhagen: a comparison of immigrant groups and Danish-born residents. Scand J Public Health. 2004; 32:53-9.
  • [13]Norredam M, Nielsen SS, Krasnik A. Migrants’ utilization of somatic healthcare services in Europe–a systematic review. Eur J Public Health. 2010; 20:555-63.
  • [14]Tarraf W, Vega W, Gonzalez HM. Emergency department services use among immigrant and non-immigrant groups in the United States. J Immigr Minor Health. 2014; 16:595-606.
  • [15]The General Practitioner (GP) scheme. 2015. https://helsenorge. no/foreigners-in-norway/general-practitioner. Accessed 25 May 2015
  • [16]Danielsen K, Førland O, Garratt A. Utvikling av metode for å måle pasienters og pårørendes erfaringer med legevakt [Developing methods to measure patients’ and relatives’ experiences with emergency health care services], vol. 2008/7. Kunnskapssenteret [The Norwegian Knowledge Centre for the Health Services], Oslo; 2008.
  • [17]Befolkning–innvandrere og norskfødte med innvandrerforeldre [Population –immigrants and Norwegian-born with immigrant parents]. 2013. http://www.ssb.no/befolkning/statistikker/innvbef/aar/2013-04-25?fane=om#content. Accessed 2 November 2013.
  • [18]Aschehoug S. Rett til helsehjelp for papirløse migranter [Health care rights for undocumented immigrants]. Tidsskr Nor Laegeforen. 2010; 130:765-6.
  • [19]Blom S. Sosiale forskjeller i innvandreres helse: funn fra undersøkelsen Levekår blant innvandrere 2005/2006 [Social differences in the health of immigrants based on data from the Survey on Living Conditions among Immigrants 2005/2006], vol. 2010/47. Statistics Norway, Oslo; 2010.
  • [20]Bråthen M. Levekår på vandring: velstand og marginalisering i Oslo [Living conditions in change: prosperity and marginalisation in Oslo], vol. 2007/05. Forskningsstiftelsen FAFO [FAFO Institute], Oslo; 2007.
  • [21]Forland F. Migrasjon og helse: utfordringer og utviklingstrekk [Migration and health: challenges and development]. Helsedirektoratet [The Norwegian Directorate of Health], Oslo; 2009.
  • [22]Pascoe EA, Smart Richman L. Perceived discrimination and health: a meta-analytic review. Psychol Bull. 2009; 135:531-54.
  • [23]Fortsatt store forskjeller i levealder i Oslo [Still major differences in life expectancy in Oslo]. 2013. http://www.ssb.no/befolkning/artikler-og-publikasjoner/fortsatt-store-forskjeller-i-levealder-i-oslo. Accessed 10 November 2013.
  • [24]Abebe DS, Lien L, Hjelde KH. What we know and don’t know about mental health problems among immigrants in Norway. J Immig Minor Health. 2014; 16:60-7.
  • [25]Jenum AK, Diep LM, Holmboe-Ottesen G, Holme IM, Kumar BN, Birkeland KI. Diabetes susceptibility in ethnic minority groups from Turkey, Vietnam, Sri Lanka and Pakistan compared with Norwegians—the association with adiposity is strongest for ethnic minority women. BMC Public Health. 2012; 12:150. BioMed Central Full Text
  • [26]Tran AT, Straand J, Diep LM, Meyer HE, Birkeland KI, Jenum AK. Cardiovascular disease by diabetes status in five ethnic minority groups compared to ethnic Norwegians. BMC Public Health. 2011; 11:554. BioMed Central Full Text
  • [27]Folkehelseinstituttet, Folkehelserapporten 2014, Kapittel: Skader og Ulykker [Norwegian Institute of Public Health, The Public Health Report 2014, Chapter: Accident and Injuries]. 2014. http://www.fhi.no/publikasjoner-og-haandboker/folkehelserapporten. Accessed 23 September 2014.
  • [28]Choi JH, Kim SH, Kim SP, Jung KY, Ryu JY, Choi SC et al.. Characteristics of intentional fall injuries in the ED. Am J Emerg Med. 2014; 32:529-34.
  • [29]Scheyerer MJ, Spuhler D, Zimmermann S, Guenkel S, Werner CL, Wanner GA et al.. Gewaltbedingte Verletzungen in einem stadtischen Umfeld aus Sicht einer unfallchirurgischen Notfallaufnahme. [Violence-related injuries in an urban environment: view from an accident and emergency department]. Praxis (Bern 1994). 2013; 102:1409-14.
  • [30]Aerny Perreten N, Ramasco Gutierrez M, Cruz Macein JL, Rodriguez Rieiro C, Garabato Gonzalez S, Rodriguez Laso A. La salud y sus determinantes en la poblacion inmigrante de la Comunidad de Madrid. [Health and its determinants in the immigrant population of the region of Madrid]. Gac Sanit. 2010; 24:136-44.
  • [31]Gholizadeh L, Salamonson Y, Worrall-Carter L, DiGiacomo M, Davidson PM. Awareness and causal attributions of risk factors for heart disease among immigrant women living in Australia. J Womens Health (Larchmt). 2009; 18:1385-93.
  • [32]Blom S. Innvandreres helse 2005/2006, [Immigrants’ health 2005/2006], vol. 2008/35. Statistics Norway, Oslo; 2008.
  • [33]Diaz E, Calderon-Larranaga A, Prado-Torres A, Poblador-Plou B, Gimeno-Feliu LA. How do immigrants use primary health care services? A register-based study in Norway. Eur J Public Health. 2015; 25:72-8.
  • [34]Diaz E, Gimeno-Feliu LA, Calderon-Larranaga A, Prados-Torres A. Frequent attenders in general practice and immigrant status in Norway: a nationwide cross-sectional study. Scand J Prim Health Care. 2014; 32:232-40.
  • [35]Mygind A, Norredam M, Nielsen AS, Bagger J, Krasnik A. The effect of patient origin and relevance of contact on patient and caregiver satisfaction in the emergency room. Scand J Public Health. 2008; 36:76-83.
  文献评价指标  
  下载次数:0次 浏览次数:3次