Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

Use of healthcare services in the region of origin among patients with an immigrant background in Denmark: a qualitative study of the motives

Authors: Nicoline Lokdam, Maria Kristiansen, Line Neerup Handlos, Marie Norredam

Published in: BMC Health Services Research | Issue 1/2016

Login to get access

Abstract

Background

In Denmark, immigrants have been found to have a higher use of healthcare services abroad. Since this use may have an impact on both the individual patient and the healthcare system in the country of residence, research into underlying reasons is of increasing relevance. This study therefore investigates what motives patients with an immigrant background have for seeking healthcare services in their region of origin.

Methods

The study was based on 10 semi-structured interviews with 10 patients who had an immigrant background, primarily originating from Turkey and the Middle East, recruited at a clinic of immigrant medicine in Denmark. The interviews were analysed thematically to elucidate motives for seeking healthcare services abroad, with focus on identifying push and pull factors.

Results

Four motives for seeking healthcare in the region of origin were salient in the material: the perception of availability, in terms of quantity and access; familiarity, conceptualised as feeling comfortable within the healthcare system; perception of quality of services; and finally, the perceived need for a second opinion. All motives emerged simultaneously as push factors, motivating immigrants to explore healthcare services abroad, and pull factors, attracting them to their country of origin. Affordability did not emerge as an independent motive but influenced the other factors.

Conclusion

The use of healthcare services abroad by patients with an immigrant background constitutes active health-seeking behaviours shaped by a range of factors perceived to be limiting access to high-quality services in Denmark. Further research, including quantitative studies, should be initiated to investigate the importance of these motives among larger, more diverse immigrant groups, consequences for treatment regimes, and the healthcare professionals’ perspective on the use of healthcare in the region of origin among immigrant patients.
Appendix
Available only for authorised users
Literature
1.
Castels S, Miller MJ. The age of migration: international population movements in the modern world. 4th ed. London: Palgrave Macmillan; 2009.
2.
Bekendtgørelse af sundhedsloven [Law on Health]. Sect. 7 (2014).
3.
United Nations. Cartographer international migration 2013 Wallchart. New York, USA. 2013.
4.
Statistics Denmark. Immigrants in Denmark 2014 (in Danish). 2014.
5.
Norredam M. Migration and health: exploring the role of migrant status through register-based studies. Dan Med J. 2015;62(4):31.
6.
Bhopal RS. Migration, ethnicity, race, and health in multicultural societies. 2nd ed. New York, USA: Oxford University Press; 2014.
7.
Su D, Wang D. Acculturation and cross-border utilization of health services. J Immigrant Minority Health. 2012;14:7.CrossRef
8.
Dijk RV. Culture as excuse: the failures of health care to migrants in the Netherlands’. In: Sjaak van der Geest AR, editor. The Art of medical anthropology: readings. Amsterdam: Het Spinhuis Publisher; 1998. p. 243.
9.
Allan Krasnik MN, Sorensenb TM, Michaelsena JJ, Nielsena AS, Keiding N. Effect of ethnic background on Danish hospital utilisation patterns. Soc Sci Med. 2002;55:1207–11.CrossRefPubMed
10.
Kleinman A. The illness narratives–suffering, healing and the human condition. United States of America: Basic Books; 1988.
11.
Slaeh WO, Bhui K, Warfa N. Acculturation, depression and identity negotiations among young second-generation Somali migrants. In: Ingleby D, Krasnik A, Lorant V, Razum O, editors. Health inequalities and risk factors among migrants and ethnic minorities. COST series on health and diversity: Garant. 2012. p. 121–34.
12.
Kessing LL, Norredam M, Kvernrod A-B, Mygind A, Kristiansen M. Contextualising migrants’ health behaviour–a qualitative study of transnational ties and their implications for participation in mammography screening. BMC Public Health. 2013;13(431):10.
13.
Dinesen C, Nielsen SS, Mortensen LH, Krasnik A. Inequality in self-rated health among immigrants, their descendants and ethnic Danes: examining the role of socioeconomic position. Int J Public Health. 2011;56:12.CrossRef
14.
Suurmond J, Uiters E, Bruijne MC, Stronks K, Essink-Bot M-L. Negative health care experiences of immigrant patients: a qualitative study. BMC Health Serv Res. 2011;11:8.CrossRef
15.
Boateng L, Nicolaou M, Dijkshoorn H, Stronks K, Agyemang C. An exploration of the enablers and barriers in access to the Dutch healthcare system among Ghanaians in Amsterdam. BMC Health Serv Res. 2012;12:11.CrossRef
16.
Nielsen SS, Yazici S, Petersen SG, Blaakilde AL, Krasnik A. Use of cross-border healthcare services among ethnic Danes, Turkish immigrants and Turkish descendants in Denmark: a combined survey and registry study. BMC Health Serv Res. 2012;12:9.CrossRef
17.
Sekercan A, Lamkaddem M, Snijder MB, Peters RJG, Essink-Bot ML. Healthcare consumption by ethnic minority people in their country of origin. Eur J Publ Health. 2014;7.
18.
Glinos IA, Baeten R, Helble M, Maarse H. A typology of cross-border patient mobility. Health Place. 2010;16:11.CrossRef
19.
20.
Lunt N, Carrera P. Medical tourism: assessing the evidence on treatment abroad. Maturitas. 2010;66:6.CrossRef
21.
Jervelund SS, Handlos LN. Use of cross-border healthcare among immigrants. In: Neil Lunt DH, Hanefeld J, editors. Handbook of medical tourism and patient mobility. 1st ed. UK: Edward Elgar Publishing; 2015.
22.
23.
Macias EP, Morales LS. Crossing the border for health care. J Health Care Poor Underserved. 2001;12:12.CrossRef
24.
Migge B, Gilmartin M. Migrants and healthcare: investigating patient mobility among migrants in Ireland. Health Place. 2011;17:6.CrossRef
25.
Jesus MD, Xiao C. Cross-border health care utilization among the Hispanic population in the United States: implications for closing the health care access gap. Ethn Health. 2012;18(3):20. doi:10.​1080/​13557858.​2012.​730610.
26.
Kvale S, Brinkmann S. Interview–Introduktion til et håndværk. 2nd ed. Denmark: Hans Reitzels Forlag; 2009.
27.
28.
World Health Organization. The world health report: health systems financing: the path to universal coverage. Geneva, Switzerland; 2010
29.
Slot LV. Equal access to health–An analysis of general practioners meeting with etnich minority patients (In Danish). Copenhagen: The Danish Institute of Human Rights; 2014.
30.
Coulter A. Engaging Patients in Healthcare. England: McGrw-Hill Education; 2011.
31.
Veatch RM. Patient, Heal Thyself. New York, New York 10016: Oxford University Press; 2009.
32.
Esholdt H. fuglsang M. Etniske forskelle i patienters oplevelser [Ethnic differences in patient experiences]. Copenhagen: Enhed for Brugerundersøgelser; 2009.
33.
34.
Jensen NK, Norredam M, Priebe S, Krasnik A. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark. BMC Family Practice. 2013;14:17.CrossRefPubMedPubMedCentral
35.
Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;358:6.CrossRef
36.
Garrett P, Dickson H, Young L, Whelan A. “The Happy Migrant Effect”: perceptions of negative experiences of healthcare by patients with little or no English: a qualitative study across seven language groups. Qual Saf Health Care. 2008;17(2):3. doi:10.​1136/​qshc.​2007.​022426.CrossRef
37.
Lou S. Three is an odd couple (In Danish). Århus, Denmark: Center of Public Health, Central Denmark Region; 2008.
Metadata
Title
Use of healthcare services in the region of origin among patients with an immigrant background in Denmark: a qualitative study of the motives
Authors
Nicoline Lokdam
Maria Kristiansen
Line Neerup Handlos
Marie Norredam
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1346-1

Other articles of this Issue 1/2016

BMC Health Services Research 1/2016 Go to the issue

Research article

Health workers’ perspectives, knowledge and skills regarding community case management of childhood diarrhoea and pneumonia: a qualitative inquiry for an implementation research project “Nigraan” in District Badin, Sindh, Pakistan

Research article

Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision

Study protocol

Study protocol: a randomised controlled trial of a nurse-led community-based self-management programme for improving recovery among community-residing stroke survivors

Research article

Clients’ satisfaction with HIV treatment services in Bamenda, Cameroon: a cross-sectional study

Research article

Evaluation of 5536 patients treated in an integrative outpatient tinnitus treatment center–immediate effects and a modeling approach for sustainability

Research article

Performance of EQ-5D, howRu and Oxford hip & knee scores in assessing the outcome of hip and knee replacements