Acceso y uso de los servicios sanitarios por parte de los pacientes inmigrantes: la voz de los profesionales / The access to health services and their use by immigrant patients: the voice of the professionals

Objetivo: Conocer, desde el punto de vista de los profesionales de la salud, cómo acceden y utilizan los servicios sanitarios los distintos colectivos de inmigrantes. Diseño: Estudio cualitativo, descriptivo y fenomenológico realizado en Barcelona entre septiembre y diciembre de 2007. Emplazamiento: El estudio se situó en las 6 áreas básicas de salud de Barcelona que tienen un mayor porcentaje de población inmigrante y en 3 hospitales públicos. Participantes y/o contexto: 73 profesionales de atención primaria y hospitalaria. Se realizó un muestreo teórico de informantes que definieron 4 perfiles profesionales: cargos directivos o coordinadores, médicos, personal de enfermería y mediadores culturales. Método: Se realizaron 7 grupos de discusión y 12 entrevistas semiestructuradas a los profesionales. Las entrevistas y grupos se analizaron mediante el análisis narrativo del contenido. Resultados: Según los profesionales, los pacientes inmigrantes no encuentran barreras que les dificulten el acceso a los servicios sanitarios. Es unánime la percepción de que el servicio de urgencias es su principal puerta de acceso y que la mayoría de pacientes inmigrantes hacen una menor continuidad asistencial. Por último, los profesionales detectan diferencias en el acceso y uso de los servicios sanitarios según el origen y según el grado de integración social del colectivo en destino. Conclusiones: Los profesionales atribuyen el mayor uso de urgencias, el acceso tardío a los servicios sanitarios y la poca continuidad asistencial a una serie de factores relacionados con la precariedad económica y a aspectos relacionados con la inclusión social. Son necesarias estrategias de inclusión social para disminuir las desigualdades(AU)

Objective: To find out, from the health professionals’ point of view, how different immigrant groups access and use the health services. Design: Qualitative, descriptive and phenomenological study carried out in Barcelona between September and December of 2007. Setting: The study was carried out in the 6 Basic Health Areas of Barcelona, where there is a higher percentage of immigrant population, and in 3 public hospitals. Participants: A total of 73 hospital and primary health care professionals. Theoretical sampling was carried out on respondents who defined 4 professional profiles: directors or coordinators, physicians, nurses, and cultural mediators. Methods: There were 7 debate groups and 12 partly-structured interviews. Both the interviews and groups were analysed by a narrative analysis of the content. Results: The outcomes indicate that, according to the professionals, the immigrant patients do not find barriers that can make their access to health services more difficult. The perception that the emergency service is their main access gate for them is unanimous, as well as that most of the immigrant patients have less continuity of care. Finally, professionals detect differences in the access and use of health services depending on their origin and the level of social integration of the immigrant group. Conclusions: Professionals attribute a higher use of emergencies, late access to the health services, and less continuity of care, to a series of factors related to economic precariousness and to aspects related to the social inclusion. There is the room for social inclusion policies to reduce these inequalities(AU)

[The access to health services and their use by immigrant patients: the voice of the professionals]. / Acceso y uso de los servicios sanitarios por parte de los pacientes inmigrantes: la voz de los profesionales.

OBJECTIVE: To find out, from the health professionals' point of view, how different immigrant groups access and use the health services. DESIGN: Qualitative, descriptive and phenomenological study carried out in Barcelona between September and December of 2007. SETTING: The study was carried out in the 6 Basic Health Areas of Barcelona, where there is a higher percentage of immigrant population, and in 3 public hospitals. PARTICIPANTS: A total of 73 hospital and primary health care professionals. Theoretical sampling was carried out on respondents who defined 4 professional profiles: directors or coordinators, physicians, nurses, and cultural mediators. METHODS: There were 7 debate groups and 12 partly-structured interviews. Both the interviews and groups were analysed by a narrative analysis of the content. RESULTS: The outcomes indicate that, according to the professionals, the immigrant patients do not find barriers that can make their access to health services more difficult. The perception that the emergency service is their main access gate for them is unanimous, as well as that most of the immigrant patients have less continuity of care. Finally, professionals detect differences in the access and use of health services depending on their origin and the level of social integration of the immigrant group. CONCLUSIONS: Professionals attribute a higher use of emergencies, late access to the health services, and less continuity of care, to a series of factors related to economic precariousness and to aspects related to the social inclusion. There is the room for social inclusion policies to reduce these inequalities.