Association Between Residence Status Regularization and Access to Healthcare for Undocumented Migrants in Switzerland: A Panel Study
BackgroundSwitzerland has a universal healthcare system. Yet, undocumented migrants face barriers at different levels that hinder their access to healthcare services. The aim of this study is to assess whether undocumented migrants' healthcare utilization improves with residence status regulari...
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.832090/full |
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| author | Julien Fakhoury Julien Fakhoury Claudine Burton-Jeangros Claudine Burton-Jeangros Liala Consoli Liala Consoli Aline Duvoisin Aline Duvoisin Yves Jackson |
| author_facet | Julien Fakhoury Julien Fakhoury Claudine Burton-Jeangros Claudine Burton-Jeangros Liala Consoli Liala Consoli Aline Duvoisin Aline Duvoisin Yves Jackson |
| author_sort | Julien Fakhoury |
| collection | DOAJ |
| description | BackgroundSwitzerland has a universal healthcare system. Yet, undocumented migrants face barriers at different levels that hinder their access to healthcare services. The aim of this study is to assess whether undocumented migrants' healthcare utilization improves with residence status regularization.MethodsWe used two-wave panel data from the Parchemins study, a study exploring the impact of regularization on undocumented migrants' health in Geneva, Switzerland. First wave data were collected between 2017 and 2018, second wave data between 2019 and 2020. At baseline, the sample consisted of 309 undocumented migrants, recruited after the implementation of a temporary regularization policy in Geneva. We distributed them into two groups according to their residence status 12 months before the second data collection [regularized vs. undocumented (controls)]. Using as dependent variable the number of medical consultations within two distinct 12-months periods (the first before regularization, the second after regularization), we conducted multivariable regression analyses applying hurdle specification to identify factors enhancing healthcare utilization. Then, we estimated first-difference panel models to assess change in healthcare utilization along regularization. Models were adjusted for demographic, economic and health-related factors.ResultsOf the 309 participants, 68 (22%) were regularized. For the 12 months before regularization, these migrants did not significantly differ in their healthcare utilization from the controls. At this stage, factors increasing the odds of having consulted at least once included being a female (aOR: 2.70; 95% CI: 1.37–5.30) and having access to a general practitioner (aOR: 3.15; 95% CI: 1.62–6.13). The factors associated with the number of consultations apart from underlying health conditions were the equivalent disposable income (aIRR per additional CHF 100.-: 0.98; 95% CI: 0.97–1.00) and having access to a general practitioner (aIRR: 1.45; 95% CI: 1.09–1.92). For the 12 months after regularization, being regularized was not associated with higher odds of having consulted at least once. However, among participants who consulted at least once, regularized ones reported higher counts of medical consultations than controls (3.7 vs. 2.6, p = 0.02), suggesting a positive impact of regularization. Results from the first-difference panel models confirmed that residence status regularization might have driven migrants' healthcare utilization (aβ: 0.90; 95% CI: 0.31-1.77).ConclusionsThis study supports the hypothesis that residence status regularization is associated with improved healthcare utilization among undocumented migrants. Future research is needed to understand the mechanisms through which regularization improves undocumented migrants' use of healthcare services. |
| first_indexed | 2024-12-12T16:31:44Z |
| format | Article |
| id | doaj.art-5c2ec7b03b994d7e8778b762a4e0fc15 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-12T16:31:44Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-5c2ec7b03b994d7e8778b762a4e0fc152022-12-22T00:18:46ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-05-011010.3389/fpubh.2022.832090832090Association Between Residence Status Regularization and Access to Healthcare for Undocumented Migrants in Switzerland: A Panel StudyJulien Fakhoury0Julien Fakhoury1Claudine Burton-Jeangros2Claudine Burton-Jeangros3Liala Consoli4Liala Consoli5Aline Duvoisin6Aline Duvoisin7Yves Jackson8Swiss National Center of Competence in Research (NCCR) “LIVES – Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, SwitzerlandInstitute of Sociological Research, University of Geneva, Geneva, SwitzerlandSwiss National Center of Competence in Research (NCCR) “LIVES – Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, SwitzerlandInstitute of Sociological Research, University of Geneva, Geneva, SwitzerlandSwiss National Center of Competence in Research (NCCR) “LIVES – Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, SwitzerlandInstitute of Sociological Research, University of Geneva, Geneva, SwitzerlandSwiss National Center of Competence in Research (NCCR) “LIVES – Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, SwitzerlandCenter for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, SwitzerlandGeneva University Hospital and University of Geneva, Geneva, SwitzerlandBackgroundSwitzerland has a universal healthcare system. Yet, undocumented migrants face barriers at different levels that hinder their access to healthcare services. The aim of this study is to assess whether undocumented migrants' healthcare utilization improves with residence status regularization.MethodsWe used two-wave panel data from the Parchemins study, a study exploring the impact of regularization on undocumented migrants' health in Geneva, Switzerland. First wave data were collected between 2017 and 2018, second wave data between 2019 and 2020. At baseline, the sample consisted of 309 undocumented migrants, recruited after the implementation of a temporary regularization policy in Geneva. We distributed them into two groups according to their residence status 12 months before the second data collection [regularized vs. undocumented (controls)]. Using as dependent variable the number of medical consultations within two distinct 12-months periods (the first before regularization, the second after regularization), we conducted multivariable regression analyses applying hurdle specification to identify factors enhancing healthcare utilization. Then, we estimated first-difference panel models to assess change in healthcare utilization along regularization. Models were adjusted for demographic, economic and health-related factors.ResultsOf the 309 participants, 68 (22%) were regularized. For the 12 months before regularization, these migrants did not significantly differ in their healthcare utilization from the controls. At this stage, factors increasing the odds of having consulted at least once included being a female (aOR: 2.70; 95% CI: 1.37–5.30) and having access to a general practitioner (aOR: 3.15; 95% CI: 1.62–6.13). The factors associated with the number of consultations apart from underlying health conditions were the equivalent disposable income (aIRR per additional CHF 100.-: 0.98; 95% CI: 0.97–1.00) and having access to a general practitioner (aIRR: 1.45; 95% CI: 1.09–1.92). For the 12 months after regularization, being regularized was not associated with higher odds of having consulted at least once. However, among participants who consulted at least once, regularized ones reported higher counts of medical consultations than controls (3.7 vs. 2.6, p = 0.02), suggesting a positive impact of regularization. Results from the first-difference panel models confirmed that residence status regularization might have driven migrants' healthcare utilization (aβ: 0.90; 95% CI: 0.31-1.77).ConclusionsThis study supports the hypothesis that residence status regularization is associated with improved healthcare utilization among undocumented migrants. Future research is needed to understand the mechanisms through which regularization improves undocumented migrants' use of healthcare services.https://www.frontiersin.org/articles/10.3389/fpubh.2022.832090/fullundocumented migrantshealthcare utilizationaccess to healthcarepolicyresidence status regularization |
| spellingShingle | Julien Fakhoury Julien Fakhoury Claudine Burton-Jeangros Claudine Burton-Jeangros Liala Consoli Liala Consoli Aline Duvoisin Aline Duvoisin Yves Jackson Association Between Residence Status Regularization and Access to Healthcare for Undocumented Migrants in Switzerland: A Panel Study Frontiers in Public Health undocumented migrants healthcare utilization access to healthcare policy residence status regularization |
| title | Association Between Residence Status Regularization and Access to Healthcare for Undocumented Migrants in Switzerland: A Panel Study |
| title_full | Association Between Residence Status Regularization and Access to Healthcare for Undocumented Migrants in Switzerland: A Panel Study |
| title_fullStr | Association Between Residence Status Regularization and Access to Healthcare for Undocumented Migrants in Switzerland: A Panel Study |
| title_full_unstemmed | Association Between Residence Status Regularization and Access to Healthcare for Undocumented Migrants in Switzerland: A Panel Study |
| title_short | Association Between Residence Status Regularization and Access to Healthcare for Undocumented Migrants in Switzerland: A Panel Study |
| title_sort | association between residence status regularization and access to healthcare for undocumented migrants in switzerland a panel study |
| topic | undocumented migrants healthcare utilization access to healthcare policy residence status regularization |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.832090/full |
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