M Esteva1, S Cabrera, D Remartinez, A Díaz, S March. 1. Unidad Docente de Medicina Familiar y Comunitaria, Gerencia Atención Primaria de Mallorca, Baleares, Spain. mesteva@ibsalut.caib.es
Abstract
OBJECTIVES: To find the problems, as seen by family doctors, in care for immigrants, with description of proposed solutions. DESIGN: Transversal and descriptive. PARTICIPANTS: 262 doctors from 18 health centres in a district. MEASUREMENTS: Each professional received a questionnaire containing social and demographic variables, number of immigrants seen per day, their place of origin, 6 items on accessibility, 5 on barriers to care, 6 on clinic, and 7 on solutions. RESULTS: 159 doctors, 57.2% women, replied. Average age was 41.1; 64% saw 2-3 immigrants a day. 52.3% (95% CI, 45.0%-61.4%) recognised that care for immigrants posed professional problems. They said that immigrants attended as an emergency more often (81.1%); they more often had no clinical records (74.7%); and they had difficulties obtaining a health card (53%). 67% expressed no difficulties for getting to the hospital. Perceived barriers were the mobility of immigrants (82.9%), language (82.3%), and culture (71.3%). Solutions suggested were translators (95.6%) or cultural intermediary (82.7%). Clinically, doctors saw no differences of pathology in immigrants (56.7%), and no greater psychiatric pathology (66%). Lack of skill in contagious pathologies hampered care (60.3%). 82.8% affirmed that specific protocols were needed. 80.3% argued for a unit of imported diseases. Among care priorities were information on health circuits and making the health card easier to obtain. CONCLUSIONS: The difficulties sustained by a broad range of professionals are diverse, with access and linguistic-cultural questions standing out. To palliate them, sensitivity from health staff and action from management are needed.
OBJECTIVES: To find the problems, as seen by family doctors, in care for immigrants, with description of proposed solutions. DESIGN: Transversal and descriptive. PARTICIPANTS: 262 doctors from 18 health centres in a district. MEASUREMENTS: Each professional received a questionnaire containing social and demographic variables, number of immigrants seen per day, their place of origin, 6 items on accessibility, 5 on barriers to care, 6 on clinic, and 7 on solutions. RESULTS: 159 doctors, 57.2% women, replied. Average age was 41.1; 64% saw 2-3 immigrants a day. 52.3% (95% CI, 45.0%-61.4%) recognised that care for immigrants posed professional problems. They said that immigrants attended as an emergency more often (81.1%); they more often had no clinical records (74.7%); and they had difficulties obtaining a health card (53%). 67% expressed no difficulties for getting to the hospital. Perceived barriers were the mobility of immigrants (82.9%), language (82.3%), and culture (71.3%). Solutions suggested were translators (95.6%) or cultural intermediary (82.7%). Clinically, doctors saw no differences of pathology in immigrants (56.7%), and no greater psychiatric pathology (66%). Lack of skill in contagious pathologies hampered care (60.3%). 82.8% affirmed that specific protocols were needed. 80.3% argued for a unit of imported diseases. Among care priorities were information on health circuits and making the health card easier to obtain. CONCLUSIONS: The difficulties sustained by a broad range of professionals are diverse, with access and linguistic-cultural questions standing out. To palliate them, sensitivity from health staff and action from management are needed.
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