Utilisation of hospital services in Italy: a comparative analysis of immigrant and Italian citizens

In Italy, immigrants from Less Developed Countries (LDCs) have doubled every 10 years since the 1970s and this number grew to 330,000 at the end of 1981, and to more than 1,300,000 in 2001. As the presence of immigrants increases, it becomes ever more important to assess their health needs and utilisation of health services, in order to promote adequate programmes and policies. This study was aimed to compare the patterns of hospital use by immigrants from LDCs living in the Lazio Region, Italy, with those of the resident Italians. The study was based on the hospital discharge data collected by the Lazio Region Hospital Information System. Discharges of immigrants from acute hospitals in Lazio during 2005 were compared with discharges of resident Italians. Age- and sex-specific hospitalisation rates (per 1,000) were also calculated for legal immigrants and Italians aged 18 years and over. Of 56,610 foreign patients from LCDs admitted to hospitals in Lazio during 2005, 88% were legally residing in the region. The immigrants were younger than the Italians (mean age 30.6 and 51.7 years, respectively), more than half were female and single, and about 1/3 had studied for 9 or more years. Among males, a similar pattern of hospital use by age was observed for foreigners and Italians, with the rates for foreigners in acute care being higher among young people (due to traumatic accidents) and lower among the oldest. Differently, among foreign females, the admission rates for both acute and day care settings varied with women's age, the pattern of hospital use being strongly influenced by reproductive events. The main reason for hospitalisation of foreign males in acute care was injuries (approximately 1/4 of all discharges), and in day care was neoplasms; among females, more than half of the admissions were for childbirth in acute or induced abortions in day care. Injuries for males and induced abortions for females were identified as critical areas for migrants' health, in which public health interventions may be promoted.