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Changes in access to health care for immigrants in Catalonia during the economic crisis: Opinions of health professionals and immigrant users

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  • Porthé, Victoria
  • Vargas, Ingrid
  • Sanz-Barbero, Belén
  • Plaza-Espuña, Isabel
  • Bosch, Lola
  • Vázquez, Maria Luisa

Abstract

Policy measures introduced in Spain during the economic crisis included a reduction in public health expenditure and in healthcare entitlements (RDL16/2012), which affected the general population as a whole, but especially immigrants. This paper analyzes changes in immigrants’ access to health care during the economic crisis from the perspective of health professionals (medical and administrative) and immigrants. A qualitative descriptive-interpretative study was conducted in Catalonia through individual interviews with a theoretical sample of health professionals (n=34) and immigrant users (n=20). Thematic analysis was conducted and data quality was ensured through triangulation. Informants described barriers to enter the health system related to reduced healthcare entitlements and a stricter enforcement of administrative requirements: while medical professionals highlighted restrictions to accessing the healthcare continuum, immigrants accentuated barriers to obtaining the individual health card. With regard to use of services, an increase in waiting times due to cutbacks in human resources dominated the informants’ discourse. Health professionals pointed out organizational changes to increase efficiency that may improve access to primary care. Informants related lower health services utilization to a deterioration in immigrants’ living and working conditions. According to health professionals, these conditions limited the use of services during working hours and led to delays in seeking care and treatment interruptions. Results show an aggravation of pre-existing barriers to health services utilization and, simultaneously, the appearance of new barriers to enter the system. These changes in the healthcare services contradict the equity principles of the national health system (NHS), thus policy decisions are needed to address this problem.

Suggested Citation

  • Porthé, Victoria & Vargas, Ingrid & Sanz-Barbero, Belén & Plaza-Espuña, Isabel & Bosch, Lola & Vázquez, Maria Luisa, 2016. "Changes in access to health care for immigrants in Catalonia during the economic crisis: Opinions of health professionals and immigrant users," Health Policy, Elsevier, vol. 120(11), pages 1293-1303.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:11:p:1293-1303
    DOI: 10.1016/j.healthpol.2016.09.005
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    References listed on IDEAS

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    1. Cimas, Marta & Gullon, Pedro & Aguilera, Eva & Meyer, Stefan & Freire, José Manuel & Perez-Gomez, Beatriz, 2016. "Healthcare coverage for undocumented migrants in Spain: Regional differences after Royal Decree Law 16/2012," Health Policy, Elsevier, vol. 120(4), pages 384-395.
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    6. Vázquez, María-Luisa & Vargas, Ingrid & Jaramillo, Daniel López & Porthé, Victoria & López-Fernández, Luis Andrés & Vargas, Hernán & Bosch, Lola & Hernández, Silvia S. & Azarola, Ainhoa Ruiz, 2016. "Was access to health care easy for immigrants in Spain? The perspectives of health personnel in Catalonia and Andalusia," Health Policy, Elsevier, vol. 120(4), pages 396-405.
    7. Gené-Badia, Joan & Gallo, Pedro & Hernández-Quevedo, Cristina & García-Armesto, Sandra, 2012. "Spanish health care cuts: Penny wise and pound foolish?," Health Policy, Elsevier, vol. 106(1), pages 23-28.
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    Cited by:

    1. Georgina Pujolar & Aida Oliver-Anglès & Ingrid Vargas & María-Luisa Vázquez, 2022. "Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review," IJERPH, MDPI, vol. 19(3), pages 1-31, February.
    2. Mar Seguí-Crespo & Natalia Cantó-Sancho & Alison Reid & José Miguel Martínez & Elena Ronda-Pérez, 2019. "Differences in Eye Health, Access to Eye Care Specialists and Use of Lenses among Immigrant and Native-Born Workers in Spain," IJERPH, MDPI, vol. 16(7), pages 1-12, April.
    3. Peralta-Gallego, Leia & Gené-Badia, Joan & Gallo, Pedro, 2018. "Effects of undocumented immigrants exclusion from health care coverage in Spain," Health Policy, Elsevier, vol. 122(11), pages 1155-1160.

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