56160 20200221144348.0 doi 10.1186/s12889-016-3127-5 sideral 95267 ART-2016-95267 eng (orcid)0000-0003-2928-6623 Gimeno-Feliu, L. Universidad de Zaragoza Global healthcare use by immigrants in Spain according to morbidity burden, area of origin, and length of stay 2016 Access copy available to the general public Unrestricted Background: The healthcare of immigrants is an important aspect of equity of care provision. Understanding how immigrants use the healthcare services based on their needs is crucial to establish effective health policy. Methods: This retrospective, observational study included the total population of Aragon, Spain (1, 251, 540 individuals, of whom 11.9 % were immigrants). Patient-level data on the use of primary, specialised, hospital, and emergency care as well as prescription drug use in 2011 were extracted from the EpiChron Cohort and compared between immigrants and nationals. Multivariable standard or zero-inflated negative binomial regression models were generated, adjusting for age, sex, length of stay, and morbidity burden. Results: The annual visit rates of immigrants were lower than those of nationals for primary care (3.3 vs 6.4), specialised care (1.3 vs 2.7), planned hospital admissions/100 individuals (1.6 vs 3.8), unplanned hospital admissions/100 individuals (2.7 vs 4.7), and emergency room visits/10 individuals (2.3 vs 2.8). Annual prescription drug costs were also lower for immigrants (€47 vs €318). These differences were only partially attenuated after adjusting for age, sex and morbidity burden. Conclusion: In a universal coverage health system offering broad legal access to immigrants, the global use of healthcare services was lower for immigrants than for nationals. These differences may be explained in part by the healthy migration effect, but also reveal possible inequalities in healthcare provision that warrant further investigation. info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI11-01126 info:eu-repo/semantics/openAccess by http://creativecommons.org/licenses/by/3.0/es/ 2.265 2016 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH 63 / 176 = 0.358 2016 Q2 T2 1.431 2016 Public Health, Environmental and Occupational Health 2016 Q1 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion (orcid)0000-0001-9064-9222 Calderón-Larrañaga, A. Diaz, E. Poblador-Plou, B. Macipe-Costa, R. (orcid)0000-0002-5704-6056 Prados-Torres, A. Universidad de Zaragoza 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 1008 615 Universidad de Zaragoza Dpto. Microb.Med.Pr.,Sal.Públ. Área Medic.Prevent.Salud Públ. 16, 1 (2016), 450 [10 pp] BMC Public Health BMC PUBLIC HEALTH 1471-2458 736063 http://zaguan.unizar.es/record/56160/files/texto_completo.pdf Versión publicada 107141 http://zaguan.unizar.es/record/56160/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:56160 articulos driver 2020-02-21-13:53:51 ARTICLE