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Int. J. Environ. Res. Public Health 2014, 11(10), 10182-10201; doi:10.3390/ijerph111010182

Changes in Access to Health Services of the Immigrant and Native-Born Population in Spain in the Context of Economic Crisis

1
Health Policy and Health Services Research Group, Health Policy Research Unit, Consorci de Salut i Social de Catalunya, Avenida Tibidabo, 21, Barcelona 08022, Spain
2
Sub-Program on Immigration and Health of the CIBERESP, Melchor Fernández Almagro, 3–5, Madrid 28029, Spain
3
National School of Public Health, Instituto de Salud Carlos III, Avda Monforte de Lemos 5, Pabellón 7, Madrid 28029, Spain
4
CIBERESP, Melchor Fernández Almagro, 3–5, Madrid 28029, Spain
5
Agència de Salut Pública de Barcelona (IIB-Sant Pau), Plaça Lesseps 1, Barcelona 08023, Spain
6
Public Health Department, University of Alicante, Carretera de San Vicente del Raspeig, s/n, Alicante 03690, Spain
7
Center for Research in Occupational Health (CISAL), Universitat Pompeu Fabra, Doctor Aiguader, 88, Barcelona 08003, Spain
8
Department of Epidemiology, Consejería de Sanidad y Política Social de la Región de Murcia, Murcia Regional Heath Authority, Ronda Levante, 11, Murcia 30008, Spain
This work is part of the MEISI I Project, see acknowledgments.
*
Author to whom correspondence should be addressed.
Received: 13 August 2014 / Revised: 17 September 2014 / Accepted: 18 September 2014 / Published: 30 September 2014
(This article belongs to the Special Issue Migrant Health)
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Abstract

Aim: To analyze changes in access to health care and its determinants in the immigrant and native-born populations in Spain, before and during the economic crisis. Methods: Comparative analysis of two iterations of the Spanish National Health Survey (2006 and 2012). Outcome variables were: unmet need and use of different healthcare levels; explanatory variables: need, predisposing and enabling factors. Multivariate models were performed (1) to compare outcome variables in each group between years, (2) to compare outcome variables between both groups within each year, and (3) to determine the factors associated with health service use for each group and year. Results: unmet healthcare needs decreased in 2012 compared to 2006; the use of health services remained constant, with some changes worth highlighting, such as the decline in general practitioner visits among autochthons and a narrowed gap in specialist visits between the two populations. The factors associated with health service use in 2006 remained constant in 2012. Conclusion: Access to healthcare did not worsen, possibly due to the fact that, until 2012, the national health system may have cushioned the deterioration of social determinants as a consequence of the financial crisis. Further studies are necessary to evaluate the effects of health policy responses to the crisis after 2012. View Full-Text
Keywords: immigration; health care utilization; access to health care; economic crisis; Spain immigration; health care utilization; access to health care; economic crisis; Spain
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Garcia-Subirats, I.; Vargas, I.; Sanz-Barbero, B.; Malmusi, D.; Ronda, E.; Ballesta, M.; Vázquez, M.L. Changes in Access to Health Services of the Immigrant and Native-Born Population in Spain in the Context of Economic Crisis. Int. J. Environ. Res. Public Health 2014, 11, 10182-10201.

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