Health care utilization by immigrants in Italy
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Health care utilization by immigrants in Italy Giuliana De Luca · Michela Ponzo · Antonio Rodríguez Andrés
Received: 26 March 2012 / Accepted: 20 November 2012 / Published online: 13 December 2012 © Springer Science+Business Media New York 2012
Abstract Healthcare utilization studies show how well documented disparities between migrants and non-migrants. Reducing such disparities is a major goal in European countries. However, healthcare utilization among Italian immigrants is under-studied. The objective of this study is to explore differences in healthcare use between immigrant and native Italians. Cross-sectional study using the latest available (2004/2005) Italian Health Conditions Survey. We estimated separate hurdle binomial negative regression models for GP, specialist, and telephone consultations and a logit model for emergency room (ER) use. We used logistic regression and zero-truncated negative binomial regression to model the zero (contact decision) and count processes (frequency decisions) respectively. Adjusting for risk factors, immigrants are significantly less likely to use healthcare services with 2.4 and 2.7 % lower utilization probability for specialist and telephone consultations, respectively. Firstand second-generation immigrants’ probability for specialist and telephone contact is significantly lower than natives’. Immigrants, ceteris paribus, have a much higher probability of using ERs than natives (0.7 %). First-generation immigrants show a higher probability of visiting ERs (1 %). GP visits show no significant difference. In conclusion Italian immigrants are much less likely to use specialist healthcare and medical telephone consultations than natives but more likely to use ERs. Hence, we report an over-use of ERs and underutilization of preventive care among immigrants. We recommend improved health policies
G. De Luca Department of Economics and Statistics, University of Calabria, via Ponte Bucci, 87036, Arcavacata di Rende, CS, Italy e-mail: [email protected] M. Ponzo (B) Department of Economics, University of Naples Federico II, Via Cintia Monte S. Angelo, 80126, Napoli, Italy e-mail: [email protected] A. R. Andrés School of Business Administration (SBA), Al Akhawayn University, P.O. Box 104, Hassan II Avenue, 53000, Ifrane, Morocco e-mail: [email protected]
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for immigrants: promotion of better information dissemination among them, simplification of organizational procedures, better communications between providers and immigrants, and an increased supply of health services for the most disadvantaged populations. Keywords
Immigrants · Health care · Italy · Count data models
JEL Classification
E20 · I1 · I11 · C35
Introduction Immigration to Italy is a relatively recent phenomenon that started in the 1970s and took off during the 1990s. This process has been fueled by the collapse of the Soviet Union, the expansion of the European Union, and political instability in Northern Africa. Immigrants come to Italy as asylum seekers, legal immigrants, refu
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