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 Sep 30;11(10):10182-201. doi: 10.3390/ijerph111010182.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Economic Recession*
  • Emigrants and Immigrants / statistics & numerical data*
  • Female
  • General Practice / statistics & numerical data*
  • Health Services / statistics & numerical data*
  • Health Services / trends
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand*
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Spain / ethnology
  • Specialization / statistics & numerical data*