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Abstract
Objectives Health status, disease spectrum and use of healthcare have been reported to vary across groups of migrants and according to the different phases of migration. However, most studies are conducted among adults. This study assesses usage of primary healthcare (PHC) by children with immigrant background compared with non-immigrant children in Norway and describes their relative morbidity burden.
Design Population-based retrospective cohort study.
Setting This study used 3 linked population-based registers in Norway for children under 18 years of age in 2008.
Main exposure and outcome measures Immigrants were defined as children with both parents born abroad, and further classified into first and second generation, and according to the World Bank income categories of their parents' country of origin. Usage and morbidity were assessed with negative binomial regression and logistic regression analyses, respectively. Further, population-attributable fraction analyses on PHC visits were conducted to estimate the impact on the primary health system.
Participants 1 168 365 children including 119 251 with immigrant background.
Results The mean number of visits to PHC for non-immigrant children was 1.40 compared with 1.19 for immigrants from high-income countries (HIC) and 1.76 for immigrants from low-income countries (LIC). Compared with non-immigrants, first generation immigrants used PHC significantly less after adjusting for age and sex (incidence risk ratio (IRR) 0.70 (HIC) to 0.93 (LIC)) while second generation immigrant children generally used PHC more (IRR 1.03 (HIC) to 1.43 (LIC)); however, the median number of visits were similar between all groups. The morbidity spectrum also varied between the groups.
Conclusions Compared with non-immigrants, the excess number of consultations attributable to immigrant groups corresponds to around 1.3% of PHC visits among children.
- PRIMARY CARE
- PUBLIC HEALTH
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Footnotes
Contributors LTF was involved in design, implementation, analysis, interpretation and writing. KAM was involved in interpretation and co-writing. ED was involved in design, implementation, analysis, interpretation and co-writing.
Funding LTF and ED were employed by the University of Bergen and KAM was funded by the Norwegian Cancer Society.
Competing interests None declared.
Ethics approval This study is part of the project ‘Immigrants’ health in Norway’ which was approved by the Regional Committee for Medical and Health Research Ethics, the Norwegian Data Inspectorate, the Norwegian Labour Welfare Service and the Norwegian Directorate of Health.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.