Health care for immigrants in Europe: Is there still consensus among country experts about principles of good practice? A Delphi study

BMC Public Health

Research Article

Rosa Puigpinós i Riera¹  Ulrike Kluge²  Natasja Koitzsch Jensen³  Ritva Mertaniemi⁴  Mindaugas Stankunas⁵  Joaquim JF Soares⁶  Christina Karamanidou⁷  Tim Greacen⁸  Attila Sárváry⁹  Marie Dauvrin^1,10  Marta Welbel^1,11  Sónia Dias^1,12  Walter Devillé^1,13  Andrea Gaddini^1,14  Christa Straßmayr^1,15  Stefan Priebe^1,16  Marija Bogic^1,16 

[1] Agency of Public Health of Barcelona, Pça. Lesseps, 1, 08023, Barcelona, Spain;Clinic for Psychiatry and Psychotherapy, Charité-University Medicine Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany;Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014, Copenhagen, Denmark;Department for Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), P.O.B. 30, FIN-00271, Helsinki, Finland;Department of Health Management, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307, Kaunas, LT, Lithuania;Department of Public Health Sciences, Section of Social Medicine, Karolinska Institutet, SE-171 76 Stockholm, and Department of Public Health Sciences, Mid Sweden University, SE-851 70, Sundsvall, Sweden;Department of Sociology, National School of Public Health, 196 Alexandras Avenue, 11521, Athens, Greece;Etablissement public de santé Maison Blanche, 18 rue Rémy de Gourmont, 75019, Paris, France;Faculty of Health Sciences at Nyíregyháza, University of Debrecen, Sóstói út 31/B, 4400, Nyíregyháza, Hungary;Institute of Health and Society, Université Catholique de Louvain, Clos Chapelle aux Champs 30.05., 1200, Brussels, Belgium;Institute of Psychiatry and Neurology, Ul. Sobieskiego 9, 02-957, Warsaw, Poland;Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 96, 1349-008, Lisbon, Portugal;International and Migrant Health, NIVEL (Netherlands Institute for Health Services Research), University of Amsterdam, Amsterdam Institute of Social Sciences Research, PO Box 1568, Otterstraat 118-124, 3500, Utrecht & Amsterdam, BN, The Netherlands;Laziosanità ASP-Public Health Agency for the Lazio Region, Via S. Costanza 53, 00198, Rome, Italy;Ludwig Boltzmann Institute for Social Psychiatry, Lazarettgasse 14A-912, 1090, Vienna, Austria;Unit for Social and Community Psychiatry, Queen Mary University of London, Newham Centre for Mental Health, E13 8SP, London, UK;

关键词: Health Care Service;    Asylum Seeker;    Delphi Process;    Undocumented Migrant;    Migrant Health;   

DOI  :  10.1186/1471-2458-11-699

 received in 2011-03-14, accepted in 2011-09-13,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundEuropean Member States are facing a challenge to provide accessible and effective health care services for immigrants. It remains unclear how best to achieve this and what characterises good practice in increasingly multicultural societies across Europe. This study assessed the views and values of professionals working in different health care contexts and in different European countries as to what constitutes good practice in health care for immigrants.MethodsA total of 134 experts in 16 EU Member States participated in a three-round Delphi process. The experts represented four different fields: academia, Non-Governmental Organisations, policy-making and health care practice. For each country, the process aimed to produce a national consensus list of the most important factors characterising good practice in health care for migrants.ResultsThe scoring procedures resulted in 10 to 16 factors being identified as the most important for each participating country. All 186 factors were aggregated into 9 themes: (1) easy and equal access to health care, (2) empowerment of migrants, (3) culturally sensitive health care services, (4) quality of care, (5) patient/health care provider communication, (6) respect towards migrants, (7) networking in and outside health services, (8) targeted outreach activities, and (9) availability of data about specificities in migrant health care and prevention. Although local political debate, level of immigration and the nature of local health care systems influenced the selection and rating of factors within each country, there was a broad European consensus on most factors. Yet, discordance remained both within countries, e.g. on the need for prioritising cultural differences, and between countries, e.g. on the need for more consistent governance of health care services for immigrants.ConclusionsExperts across Europe asserted the right to culturally sensitive health care for all immigrants. There is a broad consensus among experts about the major principles of good practice that need to be implemented across Europe. However, there also is some disagreement both within and between countries on specific issues that require further research and debate.

【 授权许可】

CC BY   
© Devillé et al; licensee BioMed Central Ltd. 2011