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International Journal of Public Health

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01-10-2011 | Original Article

Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany

Authors: Heide Glaesmer, Ulla Wittig, Elmar Braehler, Alexandra Martin, Ricarda Mewes, Winfried Rief

Published in: International Journal of Public Health | Issue 5/2011

Abstract

Objectives

There are contradictory findings on health care utilization (HCU) of immigrants compared to native-born populations. Our study focuses on this topic using a population-based approach and differentiates generational cohorts of immigrants.

Methods

In a representative population survey in Germany (N = 2,510), immigrant background/generational cohort and HCU in the preceding 12 months were screened by means of self-rating instruments.

Results

11.1% (7.0% first and 4.1% second generation) of the sample are immigrants. No differences have been detect with regard to subjective state of health, satisfaction with life and with health and functional disabilities. First generation immigrants contacted a medical specialist less likely, but they more frequently use general practitioners (GPs) than the native-born Germans and the second generation immigrants.

Conclusions

First generation immigrants show remarkable differences in HCU compared to the native-born Germans and the second generation immigrants. Their HCU seems to be focused on primary care, and access to secondary care might be complicated. It seems relevant to especially pay attention to HCU of first generation immigrants and to support equal access to care for this subgroup.

Bergmann E, Kamtsiuris P (1999) Inanspruchnahme medizinischer Leistungen (Utilization of Medical Services Available in Germany Under Statutory Sickness Insurance Facilities). Gesundheitswesen 61:138–144

Bhugra D, Still R, Furnham A, Bochner S (2004) Migration and mental health. Acta Psychiatr Scand 109:243–258PubMedCrossRef

Blais R, Maiga A (1999) Do ethnic groups use health services like the majority of the population? A study from Quebec, Canada. Soc Sci Med 48:1237–1245PubMedCrossRef

Brooks R, Rabin R, de Charro F (2003) The measurement and valuation of health status using EQ-5D: a European perspective. Kluwer Academic Press, Dordrecht

Burgos AE, Schetzina KE, Dixon LB, Mendoza FS (2005) Importance of generational status in examining access to and utilization of health care services by Mexican American children. Pediatrics 115:E322–E330PubMedCrossRef

Carrasco-Garrido P, De Miguel AG, Barrera VH, Jimenez-Garcia R (2007) Health profiles, lifestyles and use of health resources by the immigrant population resident in Spain. Eur J Public Health 17:503–507PubMedCrossRef

Claassen D, Ascoli M, Berhe T, Priebe S (2005) Research on mental disorders and their care in immigrant populations: a review of publications from Germany, Italy and the UK. European Psychiatry 20:540–549PubMedCrossRef

Dillmann U, Nilges P, Saile H, Gerbershagen HU (1994) Assessing disability in chronic pain patients. Der Schmerz 8:100–110PubMedCrossRef

Hart JT (1971) The inverse care law. Lancet 1:405–412PubMedCrossRef

Henrich G, Herschbach P (2000) Questions on life satisfaction (FLZ^M)—a short questionnaire for assessing subjective quality of life. Eur J Psychol Assess 16:155–159CrossRef

Hjelm K, Apelqvist J, Nyberg P, Sundquist J, Isacsson A (1997) Health, health care utilization and living conditions in foreign-born diabetic patients in southern Sweden. J Intern Med 242:131–141PubMedCrossRef

Hjern A, Haglund B, Persson G, Rosen M (2001) Is there equity in access to health services for ethnic minorities in Sweden? Eur J Public Health 11:147–152PubMedCrossRef

Kandula NR, Kersey M, Lurie N (2004) Assuring the health of immigrants: what the leading health indicators tell us. Annu Rev Public Health 25:357–376PubMedCrossRef

Kao DT (2009) Generational cohorts, age at arrival, and access to health services among asian and latino immigrant adults. J Health Care Poor Underserved 20:395–414PubMedCrossRef

Leclere FB, Jensen L, Biddlecom AE (1994) Health-care utilization, family context, and adaptation among immigrants to the United-States. J Health Soc Behav 35:370–384PubMedCrossRef

McKay L, Macintyre S, Ellaway A (2003) Migration and health: a review of the international literature. 12th edn. MRC (Medical Research Council) Social & Public Health Sciences Unit, Glasgow

Mewes R, Rief W, Stenzel N, Glaesmer H, Martin A, Brähler E (2009) What is “normal” disability? An investigation of disability in the general population. Pain 142:36–41PubMedCrossRef

Mohanty SA, Woolhandler S, Himmelstein DU, Pati S, Carrasquillo O, Bor DH (2005) Health care expenditures of immigrants in the United States: a nationally representative analysis. Am J Public Health 95:1431–1438PubMedCrossRef

Norredam M, Nielsen SS, Krasnik A (2009) Migrant’s utilization of somatic healthcare services in Europe—a systematic review. Eur J Public Health, http://eurpub.oxfordjournals.org/cgi/content/abstract/ckp195

Pollard CA (1984) Preliminary validity study of the pain disability index. Percept Mot Skills 59:974PubMedCrossRef

Rumbaut RG (2004) Ages, life stages, and generational cohorts: decomposing the immigrant first and second generations in the United States. Int Migr Rev 38:1160–1205CrossRef

Saxena S, Eliahoo J, Majeed A (2002) Socioeconomic and ethnic group differences in self reported health status and use of health services by children and young people in England: cross sectional study. Br Med J 325:520–523CrossRef

Schenk L (2007) Migration und Gesundheit—Entwicklung eines Erklärungs—und Analysemodells für epidemiologische Studien. Int J Public Health 52:87–96PubMedCrossRef

Schenk L, Bau AM, Borde T, Butler J, Lampert T, Neuhauser H, Razum O, Weilandt C (2006) Mindestindikatorenansatz zur Erfassung des Migrationsstatus—Empfehlungen für die epidemiologische Praxis (A basic set of indicators for mapping migrant status. Recommendations for epidemiological practice). Bundesgesundheitsblatt 49:853–860CrossRef

Statistisches Bundesamt (2006) Leben in Deutschland—Ergebnisse des Mikrozensus 2005

Steinhausen HC, Bearth-Carrari C, Metzke CW (2009) Psychosocial adaptation of adolescent migrants in a Swiss community survey. Soc Psychiatry Psychiatr Epidemiol 44:308–316PubMedCrossRef

Stronks K, Ravelli ACJ, Reijneveld SA (2001) Immigrants in the Netherlands: equal access for equal needs? J Epidemiol Community Health 55:701–707PubMedCrossRef

Zeeb H, Baune BT, Vollmer W, Cremer D, Kramer A (2004) Health situation of and health service provided for adult migrants—a survey conducted during school admittance examinations. Gesundheitswesen 66:76–84PubMedCrossRef

Title: Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany
Authors: Heide Glaesmer
Ulla Wittig
Elmar Braehler
Alexandra Martin
Ricarda Mewes
Winfried Rief
Publication date: 01-10-2011
Publisher: SP Birkhäuser Verlag Basel
Published in: International Journal of Public Health / Issue 5/2011
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-010-0205-9

At a glance: The STEP trials

Springer Medicine

Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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