The access to health services and their use by immigrant patients: the voice of the professionals

Objective: To find out, from the health professionals' point of view, how different immigrant groups access and use the health services. Design: Qualitative, descriptive and phenomenological study carried out in Barcelona between September and December of 2007. Setting: The study was carried out in the 6 Basic Health Areas of Barcelona, where there is a higher percentage of immigrant population, and in 3 public hospitals. Participants: A total of 73 hospital and primary health care professionals. Theoretical sampling was carried out on respondents who defined 4 professional profiles: directors or coordinators, physicians, nurses, and cultural mediators. Methods: There were 7 debate groups and 12 partly-structured interviews. Both the interviews and groups were analysed by a narrative analysis of the content. Results: The outcomes indicate that, according to the professionals, the immigrant patients do not find barriers that can make their access to health services more difficult. The perception that the emergency service is their main access gate for them is unanimous, as well as that most of the immigrant patients have less continuity of care. Finally, professionals detect differences in the access and use of health services depending on their origin and the level of social integration of the immigrant group. Conclusions: Professionals attribute a higher use of emergencies, late access to the health services, and less continuity of care, to a series of factors related to economic precariousness and to aspects related to the social inclusion. There is the room for social inclusion policies to reduce these inequalities. (c) 2010 Elsevier Espana, S.L. All rights reserved.