Migrants’ Health Policies and Access to Health Care in Portugal within the European Framework
Abstract
:1. Introduction
2. Materials and Methods
2.1. Document Analysis
2.2. Secondary Statistical Data
2.3. Survey
3. Results
3.1. Health Policy
3.2. Health Status
3.2.1. Self-Perceived Health
3.2.2. Chronic Morbidity
3.2.3. Activity Limitation
3.3. Health Care Services
3.3.1. Self-Reported Unmet Needs for Medical Examination
3.3.2. Migrant Health Care Access in European Union
3.4. Health Care during COVID-19
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Indicators—Variables | Time | Geopolitical Territory | Source |
---|---|---|---|
Health status—Self-perceived health (%) | 2019–2020 | European Union—28 countries | Eurostat |
Health status—People having a long-standing illness or health problem (%) | 2019–2020 | European Union—28 countries | Eurostat |
Health status—Self-perceived long-standing limitations in usual activities due to health problem (%) | 2019–2020 | European Union—28 countries | Eurostat |
Health care—Self-reported unmet needs for medical examination by main reasons declared (%) | 2019–2020 | European Union—28 countries | Eurostat |
Migrant Integration Policy—Overall score (index) | 2019 | European Union—28 countries | Mipex |
Migrant Integration Policy—Overall score with health (index) | 2019 | European Union—28 countries | Mipex |
Migrant Integration Policy—Health (index) | 2019 | European Union—28 countries | Mipex |
Integration Policy Indicators | |||
---|---|---|---|
Geopolitical Territory | Overall Score (with Health) | Overall Score | Health |
Sweden | 86 | 87 | 83 |
Finland | 85 | 87 | 67 |
Portugal | 81 | 84 | 65 |
Belgium | 69 | 69 | 73 |
Ireland | 64 | 61 | 85 |
Luxembourg | 64 | 66 | 46 |
Spain | 60 | 57 | 81 |
Germany | 58 | 58 | 63 |
Italy | 58 | 55 | 79 |
Netherlands | 57 | 56 | 65 |
France | 56 | 55 | 65 |
United Kingdom | 56 | 54 | 75 |
Czechia | 50 | 48 | 61 |
Estonia | 50 | 53 | 29 |
Denmark | 49 | 48 | 56 |
Romania | 49 | 50 | 46 |
EU28 | 49 | 50 | 53 |
Malta | 48 | 47 | 56 |
Slovenia | 48 | 50 | 33 |
Austria | 46 | 41 | 81 |
Greece | 46 | 46 | 48 |
Hungary | 43 | 45 | 29 |
Cyprus | 41 | 41 | 36 |
Bulgaria | 40 | 41 | 29 |
Poland | 40 | 42 | 27 |
Croatia | 39 | 41 | 27 |
Slovakia | 39 | 37 | 50 |
Latvia | 37 | 38 | 31 |
Lithuania | 37 | 38 | 31 |
2019 | 2020 | ||||
---|---|---|---|---|---|
EU28 | EA19 | PT | PT | ||
Too expensive | Foreign population (total) | 1 | 1 | 1.3 | 1.1 |
Foreign population (Non-EU28 countries) | 1.1 | 1.2 | 1 | 1.2 | |
Foreign population (EU28 countries) | 0.8 | 0.8 | 2.6 | 0.7 | |
National population | 0.9 | 0.8 | 1.4 | 1.1 | |
Too far to travel | Foreign population (total) | 0.1 | 0 | 0 | 0.1 |
Foreign population (Non-EU28 countries) | 0.1 | 0 | 0 | 0 | |
Foreign population (EU28 countries) | 0 | 0 | 0.1 | 0.3 | |
National population | 0.1 | 0 | 0 | 0.1 | |
No time | Foreign population (total) | 0.3 | 0.2 | 0.2 | 0.3 |
Foreign population (Non-EU28 countries) | 0.3 | 0.2 | 0.1 | 0.4 | |
Foreign population (EU28 countries) | 0.2 | 0.1 | 0.3 | 0 | |
National population | 0.3 | 0.2 | 0.2 | 0.2 | |
Didn’t know any doctor or specialist | Foreign population (total) | 0.1 | 0 | 0 | 0 |
Foreign population (Non-EU28 countries) | 0.1 | 0.1 | 0 | 0 | |
Foreign population (EU28 countries) | 0.1 | 0 | 0 | 0 | |
National population | 0.1 | 0 | 0 | 0 | |
Waiting list | Foreign population (total) | 0.8 | 0.3 | 0.2 | 0.2 |
Foreign population (Non-EU28 countries) | 0.9 | 0.4 | 0.3 | 0.2 | |
Foreign population (EU28 countries) | 0.7 | 0.3 | 0 | 0 | |
National population | 1 | 0.5 | 0.3 | 0.5 | |
Fear of doctor, hospital, examination or treatment | Foreign population (total) | 0.1 | 0.1 | 0.1 | 0 |
Foreign population (Non-EU28 countries) | 0.1 | 0.1 | 0.1 | 0 | |
Foreign population (EU28 countries) | 0.1 | 0.1 | 0.1 | 0 | |
National population | 0.1 | 0.1 | 0.3 | 0.3 | |
Wanted to wait and see if the problem got better on its own | Foreign population (total) | 0.3 | 0,2 | 0,4 | 0.2 |
Foreign population (Non-EU28 countries) | 0.3 | 0,2 | 0,5 | 0.1 | |
Foreign population (EU28 countries) | 0.2 | 0,1 | 0,1 | 0.5 | |
National population | 0.6 | 0,3 | 0,4 | 0.3 | |
No unmet needs to declare | Foreign population (total) | 96.7 | 97.8 | 97.4 | 97.3 |
Foreign population (Non-EU28 countries) | 96.4 | 97.6 | 97.7 | 97 | |
Foreign population (EU28 countries) | 97 | 98.2 | 96.4 | 98.1 | |
National population | 96.5 | 97.9 | 97.3 | 96 |
Country | Health Profiles 2019 |
---|---|
Austria | Population coverage by health system is near-universal, including registered asylum seekers. Asylum seekers have good accessibility to outpatient clinics in public hospitals. A small number of people remain uninsured, including irregular migrants [32]. |
Belgium | Large population covered for health services. Asylum seekers are entitled to medical care as the responsibility of reception centers that pays for any needed medical services. Irregular migrants are not covered and are excluded from the population covered because of the lack of legal resident authorization or regular address [33]. |
Bulgaria | Lack of health system coverage as barrier to access to medical care for a considerable proportion of the population. Irregular migrants and population without a valid ID card (are not covered) [34]. |
Cyprus | Only three quarters of residents are being covered free of charge to access the public health service (under the old system). The new General Health Care System aims to provide health coverage for third country nationals with legal residence and documented asylum seekers [35]. |
Czechia | Most of the population benefited from the health system which is linked to permanent residence. Asylum seekers are also covered, but non-EU population, who are not employed or self-employed in Czechia, must purchase private health insurance to be allowed to stay in the country and have access to health care [36]. |
Estonia | Many populations have not been granted access for their health needs. The non-Estonian-speaking population, near a quarter of the population, is more likely to be uninsured for health access [37]. |
Finland | Public health services are provided to all permanent residents if they are registered as residents in one of the municipalities. Irregular immigrants and asylum seekers who have not been granted asylum are the only people not covered by health services [38]. |
France | The public health system covers most of the population, including costs for medical services provided in and outside hospitals. Irregular immigrants have access to a standard health benefit package [39]. |
Germany | Health system coverage is mostly universal with a broad social benefit to population. Refugees, asylum seekers and irregular migrants have limited coverage and access to health care services, depending on their individual status [40]. |
Greece | Universal coverage for health care for all population. Irregular migrants and asylum seekers (until they receive refugee status) and Roma population face further barriers in access to health services [41]. |
Italy | Nearly all resident populations have automatic coverage of health services, including legal foreign residents, and have access to universal health care and medical services. Irregular immigrants’ access to health coverage in urgent and essential services [42]. |
Luxembourg | Good coverage for health services to resident population with limitations for some vulnerable population groups, such as third-country nationals, for who inequalities to health access are higher [43]. |
Malta | All resident population are covered by health system, as well as refugees and asylum seekers with a good population coverage. Free health care includes migrants, but with exclusions for those who are not entitled to work in the formal sector [44]. |
Portugal | Residents are covered by health system, including all immigrants (who are in Portugal for more than 90 days) regardless of their legal status. Irregular migrants have granted access to public health services but face some barriers such as language and cultural differences [45]. |
Romania | Health system aims to provide universal coverage. Those who are not covered by health system have access to a restricted minimum benefit package. The number of population without coverage is difficult to quantify (data are reported for the general population only and statistics by ethnic group is prohibited), but people without an identification document are excluded from statutory coverage [46]. |
Slovakia | Health system provides a comprehensive benefit package to nearly the entire population and is generally good, though hospital-centric. The Roma have guaranteed access to health care on equal terms, but with a low use of health services marked by limitations such as language, cultural and information barriers, and discrimination [47]. |
Slovenia | Mostly all population residents are covered by health system if having permanent residency. Undocumented migrants, ethnic minorities and people with difficulty to meet formal residency requirements are excluded from health care access [48]. |
Spain | Nearly all populations have access to health services provided and covered by the health system, but irregular migrants and asylum seekers face greater barriers in accessing health care [49]. |
Sweden | All residents are automatically entitled to public health services, including new immigrants, and access to health care is generally good [50]. |
United Kingdom | Health services are granted to people who are normal residents. Access to services is based on need rather than ability to pay. Irregular migrants have a limited benefit package that covers some health care. Non-European Economic Area migrants (until they have been awarded ‘indefinite leave to remain’) are required to pay for health services, but refugees and asylum seekers have free access to it [51]. |
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Casquilho-Martins, I.; Ferreira, S. Migrants’ Health Policies and Access to Health Care in Portugal within the European Framework. Societies 2022, 12, 55. https://doi.org/10.3390/soc12020055
Casquilho-Martins I, Ferreira S. Migrants’ Health Policies and Access to Health Care in Portugal within the European Framework. Societies. 2022; 12(2):55. https://doi.org/10.3390/soc12020055
Chicago/Turabian StyleCasquilho-Martins, Inês, and Soraia Ferreira. 2022. "Migrants’ Health Policies and Access to Health Care in Portugal within the European Framework" Societies 12, no. 2: 55. https://doi.org/10.3390/soc12020055