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Health care utilization by immigrants in Italy

Author

Listed:
  • Giuliana Luca
  • Michela Ponzo
  • Antonio Andrés

Abstract

Healthcare utilization studies show how well documented disparities between migrants and non-migrants. Reducing such disparities is a major goal in European countries. However, healthcare utilization among Italian immigrants is under-studied. The objective of this study is to explore differences in healthcare use between immigrant and native Italians. Cross-sectional study using the latest available (2004/2005) Italian Health Conditions Survey. We estimated separate hurdle binomial negative regression models for GP, specialist, and telephone consultations and a logit model for emergency room (ER) use. We used logistic regression and zero-truncated negative binomial regression to model the zero (contact decision) and count processes (frequency decisions) respectively. Adjusting for risk factors, immigrants are significantly less likely to use healthcare services with 2.4 and 2.7 % lower utilization probability for specialist and telephone consultations, respectively. First- and second-generation immigrants’ probability for specialist and telephone contact is significantly lower than natives’. Immigrants, ceteris paribus, have a much higher probability of using ERs than natives (0.7 %). First-generation immigrants show a higher probability of visiting ERs (1 %). GP visits show no significant difference. In conclusion Italian immigrants are much less likely to use specialist healthcare and medical telephone consultations than natives but more likely to use ERs. Hence, we report an over-use of ERs and under-utilization of preventive care among immigrants. We recommend improved health policies for immigrants: promotion of better information dissemination among them, simplification of organizational procedures, better communications between providers and immigrants, and an increased supply of health services for the most disadvantaged populations. Copyright Springer Science+Business Media New York 2013

Suggested Citation

  • Giuliana Luca & Michela Ponzo & Antonio Andrés, 2013. "Health care utilization by immigrants in Italy," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 1-31, March.
    • Handle: RePEc:kap:ijhcfe:v:13:y:2013:i:1:p:1-31
    DOI: 10.1007/s10754-012-9119-9
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    as
    1. Deb, Partha & Trivedi, Pravin K., 2002. "The structure of demand for health care: latent class versus two-part models," Journal of Health Economics, Elsevier, vol. 21(4), pages 601-625, July.
    2. George J. Borjas, 2000. "The Economic Progress of Immigrants," NBER Chapters, in: Issues in the Economics of Immigration, pages 15-50, National Bureau of Economic Research, Inc.
    3. José-Ignacio Antón & Rafael Muñoz de Bustillo, 2010. "Health care utilisation and immigration in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 487-498, October.
    4. Pita Barros, Pedro & Medalho Pereira, Isabel, 2009. "Health Care and Health Outcomes of Migrants: Evidence from Portugal," MPRA Paper 18201, University Library of Munich, Germany.
    5. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    6. Daniela del Boca & Alessandra Venturini, 2001. "Italian Migration," CHILD Working Papers wp26_01, CHILD - Centre for Household, Income, Labour and Demographic economics - ITALY.
    7. Nauenberg, Eric & Laporte, Audrey & Shen, Leilei, 2011. "Social capital, community size and utilization of health services: A lagged analysis," Health Policy, Elsevier, vol. 103(1), pages 38-46.
    8. Guillermina Jasso & Douglas S. Massey & Mark R. Rosenzweig & James P. Smith, 2004. "Immigrant Health--Selectivity and Acculturation," Labor and Demography 0412002, University Library of Munich, Germany.
    9. Hugo Benítez-Silva & Moshe Buchinsky & Hiu Man Chan & Sofia Cheidvasser & John Rust, 2004. "How large is the bias in self-reported disability?," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(6), pages 649-670.
    10. Daniele Fabbri & Chiara Monfardini, 2003. "Public vs. Private Health Care Services Demand in Italy," Giornale degli Economisti, GDE (Giornale degli Economisti e Annali di Economia), Bocconi University, vol. 62(1), pages 93-123, April.
    11. Borjas, George J. (ed.), 2000. "Issues in the Economics of Immigration," National Bureau of Economic Research Books, University of Chicago Press, edition 1, number 9780226066318, December.
    12. Allin, S. & Masseria, C. & Mossialos, E., 2009. "Measuring socioeconomic differences in use of health care services by wealth versus by income," American Journal of Public Health, American Public Health Association, vol. 99(10), pages 1849-1855.
    13. Crimmins, E.M. & Kim, J.K. & Alley, D.E. & Karlamangla, A. & Seeman, T., 2007. "Hispanic paradox in biological risk profiles," American Journal of Public Health, American Public Health Association, vol. 97(7), pages 1305-1310.
    14. George France & Francesco Taroni & Andrea Donatini, 2005. "The Italian health‐care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 187-202, September.
    15. Stephen Birch & John Eyles & K. Bruce Newbold, 1993. "Equitable access to health care: Methodological extensions to the analysis of physician utilization in Canada," Health Economics, John Wiley & Sons, Ltd., vol. 2(2), pages 87-101, July.
    16. Nolan, Anne, 2012. "The ‘healthy immigrant’ effect: initial evidence for Ireland," Health Economics, Policy and Law, Cambridge University Press, vol. 7(3), pages 343-362, July.
    17. Heide Glaesmer & Ulla Wittig & Elmar Braehler & Alexandra Martin & Ricarda Mewes & Winfried Rief, 2011. "Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 56(5), pages 541-548, October.
    18. Vuong, Quang H, 1989. "Likelihood Ratio Tests for Model Selection and Non-nested Hypotheses," Econometrica, Econometric Society, vol. 57(2), pages 307-333, March.
    19. Wagstaff, Adam, 1986. "The demand for health : Some new empirical evidence," Journal of Health Economics, Elsevier, vol. 5(3), pages 195-233, September.
    20. George J. Borjas, 2000. "Issues in the Economics of Immigration," NBER Books, National Bureau of Economic Research, Inc, number borj00-1, March.
    21. Sisira Sarma & Wayne Simpson, 2006. "A microeconometric analysis of Canadian health care utilization," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 219-239, March.
    22. Winfried Pohlmeier & Volker Ulrich, 1995. "An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 30(2), pages 339-361.
    23. Santos Silva, Joao M. C. & Windmeijer, Frank, 2001. "Two-part multiple spell models for health care demand," Journal of Econometrics, Elsevier, vol. 104(1), pages 67-89, August.
    24. Dunlop, Sheryl & Coyte, Peter C. & McIsaac, Warren, 2000. "Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(1), pages 123-133, July.
    25. Ulf‐G. Gerdtham & Pravin K. Trivedi, 2001. "Equity in Swedish health care reconsidered: new results based on the finite mixture model," Health Economics, John Wiley & Sons, Ltd., vol. 10(6), pages 565-572, September.
    26. Grossman, Michael, 1982. "The demand for health after a decade," Journal of Health Economics, Elsevier, vol. 1(1), pages 1-3, May.
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    Cited by:

    1. Chun-Chih Chen & Yen-Ju Lin & Ying-Tzu Lin, 2013. "Awareness and utilization of preventive care services among the elderly under National Health Insurance," International Journal of Health Economics and Management, Springer, vol. 13(3), pages 247-260, December.
    2. Gabriella Berloffa & Francesca Paolini, 2019. "Decomposing Immigrant Differences in Physical and Mental Health: A 'Beyond the Mean' Analysis," DEM Working Papers 2019/4, Department of Economics and Management.
    3. Sweetman, A. & van Ours, J.C., 2014. "Immigration : What About the Children and Grandchildren?," Discussion Paper 2014-009, Tilburg University, Center for Economic Research.
    4. Bettin, Giulia & Sacchi, Agnese, 2020. "Health spending in Italy: The impact of immigrants," European Journal of Political Economy, Elsevier, vol. 65(C).
    5. Gabriella Berloffa & Francesca Paolini, 2022. "Going "beyond the mean" in analysing immigrant health disparities," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 47(7), pages 161-198.
    6. Astri Syse & Bjorn H. Strand & Oyvind Naess & Ólöf Anna Steingrímsdóttir & Bernadette N. Kumar, 2016. "Differences in all-cause mortality," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 34(22), pages 615-656.
    7. Ugolini, Cristina & Lippi Bruni, Matteo & Leucci, Anna Caterina & Fiorentini, Gianluca & Berti, Elena & Nobilio, Lucia & Moro, Maria Luisa, 2019. "Disease management in diabetes care: When involving GPs improves patient compliance and health outcomes," Health Policy, Elsevier, vol. 123(10), pages 955-962.
    8. Sónia Dias & Adilson Marques & Ana Gama & Maria O. Martins, 2014. "HIV Risky Sexual Behaviors and HIV Infection Among Immigrants: A Cross-Sectional Study in Lisbon, Portugal," IJERPH, MDPI, vol. 11(8), pages 1-15, August.

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    More about this item

    Keywords

    Immigrants; Health care; Italy; Count data models; E20; I1; I11; C35;
    All these keywords.

    JEL classification:

    • E20 - Macroeconomics and Monetary Economics - - Consumption, Saving, Production, Employment, and Investment - - - General (includes Measurement and Data)
    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions

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