TY - JOUR

T1 - Is there Equity in Use of Healthcare Services among immigrants, their descendents, and ethnic Danes?

AU - Nielsen, Signe Smith

AU - Hempler, Nana Folmann

AU - Waldorff, Frans Boch

AU - Kreiner, Svend

AU - Krasnik, Allan

PY - 2012/5/25

Y1 - 2012/5/25

N2 - Background: Legislation in Denmark explicitly states the right to equal access to healthcare. Nevertheless, inequities may exist; accordingly evidence is needed. Our objective was to investigate whether differences in healthcare utilization in immigrants, their descendents, and ethnic Danes could be explained by health status, socioeconomic factors, and integration. Methods: We conducted a nationwide survey in 2007 with 4,952 individuals aged 18–66 comprising ethnic Danes; immigrants from the former Yugoslavia, Iran, Iraq, Lebanon, Pakistan, Somalia, Turkey; and Turkish and Pakistani descendents. Data were linked to registries on healthcare utilization. Using Poisson regression models, contacts to hospital, emergency room (ER), general practitioner (GP), specialist in private practice, and dentist were estimated. Analyses were adjusted for health symptoms, sociodemographic factors, and proxies of integration. Results: In adjusted analyses, immigrants and their descendents had increased use of ER (multiplicative effect=1.19–5.02 dependent on immigrant and descendent group) and less frequent contact to dentist (multiplicative effect=0.04–0.80 dependent on the group). For hospitalization, GP, and specialist doctor, physical health symptoms had positive but different explanatory effects within groups; however, most immigrant and descendent groups had increased use of services compared with that of ethnic Danes. Socioeconomic position and integration had no systematic effect on the use in the different groups. Conclusion: The Danish healthcare system seems responsive to health across different population groups. We found no systematic pattern of inequity in use of free-of-charge healthcare services, but for dentists, who require co-payment, we found inequity among immigrants and descendents compared with ethnic Danes.

AB - Background: Legislation in Denmark explicitly states the right to equal access to healthcare. Nevertheless, inequities may exist; accordingly evidence is needed. Our objective was to investigate whether differences in healthcare utilization in immigrants, their descendents, and ethnic Danes could be explained by health status, socioeconomic factors, and integration. Methods: We conducted a nationwide survey in 2007 with 4,952 individuals aged 18–66 comprising ethnic Danes; immigrants from the former Yugoslavia, Iran, Iraq, Lebanon, Pakistan, Somalia, Turkey; and Turkish and Pakistani descendents. Data were linked to registries on healthcare utilization. Using Poisson regression models, contacts to hospital, emergency room (ER), general practitioner (GP), specialist in private practice, and dentist were estimated. Analyses were adjusted for health symptoms, sociodemographic factors, and proxies of integration. Results: In adjusted analyses, immigrants and their descendents had increased use of ER (multiplicative effect=1.19–5.02 dependent on immigrant and descendent group) and less frequent contact to dentist (multiplicative effect=0.04–0.80 dependent on the group). For hospitalization, GP, and specialist doctor, physical health symptoms had positive but different explanatory effects within groups; however, most immigrant and descendent groups had increased use of services compared with that of ethnic Danes. Socioeconomic position and integration had no systematic effect on the use in the different groups. Conclusion: The Danish healthcare system seems responsive to health across different population groups. We found no systematic pattern of inequity in use of free-of-charge healthcare services, but for dentists, who require co-payment, we found inequity among immigrants and descendents compared with ethnic Danes.

KW - Faculty of Health and Medical Sciences

KW - forbrug af sundhedsydelser

KW - indvandrere

KW - efterkommere

KW - lighed

KW - danske sundhedsvæsen

KW - selvvurderet helbred

M3 - Journal article

VL - 40

SP - 260

JO - Acta socio-medica Scandinavica

JF - Acta socio-medica Scandinavica

SN - 1403-4948

IS - 3

ER -