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Background: Legislation in Denmark explicitly states the right to equal access to healthcare. Nevertheless, inequities may exist; accordingly evidence is needed. Our objective was to investigate whether differences in healthcare utilization in immigrants, their descendents, and ethnic Danes could be explained by health status, socioeconomic factors, and integration. Methods: We conducted a nationwide survey in 2007 with 4,952 individuals aged 18–66 comprising ethnic Danes; immigrants from the former Yugoslavia, Iran, Iraq, Lebanon, Pakistan, Somalia, Turkey; and Turkish and Pakistani descendents. Data were linked to registries on healthcare utilization. Using Poisson regression models, contacts to hospital, emergency room (ER), general practitioner (GP), specialist in private practice, and dentist were estimated. Analyses were adjusted for health symptoms, sociodemographic factors, and proxies of integration. Results: In adjusted analyses, immigrants and their descendents had increased use of ER (multiplicative effect=1.19–5.02 dependent on immigrant and descendent group) and less frequent contact to dentist (multiplicative effect=0.04–0.80 dependent on the group). For hospitalization, GP, and specialist doctor, physical health symptoms had positive but different explanatory effects within groups; however, most immigrant and descendent groups had increased use of services compared with that of ethnic Danes. Socioeconomic position and integration had no systematic effect on the use in the different groups. Conclusion: The Danish healthcare system seems responsive to health across different population groups. We found no systematic pattern of inequity in use of free-of-charge healthcare services, but for dentists, who require co-payment, we found inequity among immigrants and descendents compared with ethnic Danes.

Adgang til sundhedsydelser afhænger af migrantstatus og reguleres i Danmark på forskelligt lovgrundlag. For indvandrere og personer med flygtningestatus reguleres adgangen til sundhedsvæsenet hovedsagelig på baggrund af sundhedsloven, idet disse migrantgrupper bliver tilmeldt Folkeregisteret. Når det drejer sig om asylansøgere, udokumenterede migranter og personer, der har været udsat for menneskehandel, er det udlændingeloven, der sætter rammerne for adgang til sundhedsvæsenet ved alt andet end akut behandling. Dermed er de mest sårbare og udsatte migrantgrupper også dem, der har færrest anerkendte rettigheder i forhold til adgang til sundhedsbehandling.

Introduktion: Levering af sundhedsydelser til indvandrere er et felt, der er under udvikling og som der er stigende opmærksomhed omkring. Morbiditets- og mortalitetsmønstre hos indvandrere vil ofte adskille sig fra majoritetsbefolkningens og i mange tilfælde ses dårlige sundhedsudfald for indvandrerpopulationerne. Desuden rapporteres der i danske såvel som udenlandske studier, at sundhedsprofessionelle støder på problemer i mødet med indvandrerpatienterne. Materiale og metoder: En Delphi-proces med fokus på ’best practice i levering af sundhedsydelser til indvandrere’ blev gennemført med otte danske eksperter fra den akademiske verden (2), NGO’er (1), politiske beslutningstagere (2) og praktiserende behandlere (3). Eksperterne foreslog indledningsvist 60 forskellige faktorer af betydning for levering af sundhedsydelser til indvandrere. Disse blev kondenseret til 32 faktorer inden faktorerne blev genudsendt til eksperterne. I første omgang blev de udsendt til eksperterne for at vurdere vigtigheden af hver enkelt faktor og dernæst med henblik på at opnå konsensus mellem de deltagende eksperter. Data er blevet indsamlet i perioden fra juni 2008 til januar 2009 og er sket som led i et større EU-projekt. Resultater: I artiklen præsenteres de 11 faktorer, der af eksperterne er vurderet til at have den største betydning for levering af sundhedsydelser til indvandrere. De tre vigtigste faktorer udgøres af adgang til tolke, kvalitet af tolkeservice og sikre compliance inden for medicinområdet. Disse efterfølges af faktorerne at have tilstrækkelig tid i konsultationen, sammenhæng i tilbud, interdisciplinært samarbejde, afsættelse af ressourcer, behandlerens rolle, anerkendelse af den enkelte patient, uddannelse af sundhedsprofessionelle og studerende samt tolkning over telefonen. Konklusion: En Delphi-proces kan være et værdifuldt værktøj til at opnå konsensus blandt eksperter inden for det undersøgte område – i dette tilfælde i forhold til le

Background: Utilization of services is an important aspect of migrants’ access to healthcare. The aim was to review the European literature on utilization of somatic healthcare services related to screening, general practitioner, specialist, emergency room and hospital by adult first-generation migrants. Our study question was: ‘Are there differences in migrants’ utilization of somatic healthcare services compared to non-migrants?’ Methods: Publications were identified by a systematic search of PUBMED and EMBASE. Appropriateness of the studies was judged independently by two researchers based on the abstracts. Additional searches were conducted via the references of the selected articles. The final number of studies included was 21. Results: The results suggested a diverging picture regarding utilization of somatic healthcare services by migrants compared to non-migrants in Europe. Overall, migrants tended to have lower attendance and referral rates to mammography and cervical cancer screening, more contacts per patient to general practitioner but less use of consultation by telephone, and same or higher level of use of specialist care as compared to non-migrants. Emergency room utilization showed both higher, equal and lower levels of utilization for migrants compared to non-migrants, whereas hospitalization rates were higher than or equal to non-migrants. Conclusion: Our review illustrates lack of appropriate epidemiological data and diversity in the categorization of migrants between studies, which makes valid cross-country comparisons most challenging. After adjusting for socio-economic factors and health status, the existing studies still show systematic variations in somatic healthcare utilization between migrants and non-migrants., categorization of migrants bet

Udgivelsesdato: 2009, BackgroundAvailable registry data on healthcare utilization which allow for identification on migrants on a national/regional basis were only reported in 11 EU countries: Austria, Belgium, Denmark, Finland, Greece, Italy, Luxembourg, the Netherlands, Poland, Slovenia, and Sweden. Data on hospital care, including surgical procedures, were most frequently available whereas only few countries had data on care outside the hospital. Regarding identification of migrants, five countr

Udgivelsesdato: 2009

Among asylum-seeking children aged 4-16 years living in the asylum centres managed by the Danish Red Cross in 2006, we investigated mental health in relation to length of stay and number of relocations. Mental health was evaluated using the Strengths and Difficulties Questionnaire (SDQ). We found that children who had been asylum-seeking for more than one year had an increased risk of having mental difficulties (odds ratio 5.5; 95% confidence interval 1.8-16.3); four or more relocations in the asylum system were also associated with a higher risk of mental problems (odds ratio 3,0; 1,4-6,7). Udgivelsesdato: 2009-Mar-16

Udgivelsesdato: 2008

Udgivelsesdato: 1. maj

Undersøgelsens formål var at kortlægge det psykiske helbred blandt asylbørn i Danmark. Alle asylbørn på 4-16 år, der boede på Dansk Røde Kors' asylcentre blev i efteråret 2006 omfattet af undersøgelsen, og 95 % (246) børn deltog. Til vurdering af børnenes psykiske helbred blev der anvendt Strengths and Difficulties Questionnaire (SDQ) samt fire spørgsmål fra Health Behaviour in School-aged Children-spørgeskemaet (HBSC). For de 4-11-årige udfyldte pædagoger og lærere spørgeskemaer, de 11-16-årige besvarede derudover også selv spørgeskemaer. Resultaterne viste, at 35% af de 4-16-årige asylbørn havde tegn på psykisk lidelse på baggrund af pædagog- og lærerbesvarelser, mens 58 % af de 11-16-årige havde tegn på psykisk lidelse på baggrund af en kombination af lærerbesvarelser og selvrapportering. De fundne resultater fra SDQ understøttes af resultaterne fra HBSC, som viste, at asylbørnene havde adskillige fysiske og psykiske symptomer, ringe selvvurderet livskvalitet og skrøbeligt socialt netværk.