Providing targeted healthcare services for immigrants with complex health needs

Providing targeted healthcare for immigrants with complex needs is an innovative approach to reducing health inequities. This study explores sociodemographic characteristics, symptoms and morbidity patterns of patients attending one such pioneering clinic.

This was a cross-sectional survey based on 408 patients seen from 1 January 2014 to 20 November 2017. Data on socio-demographics, referral patterns, migration background, symptoms and multimorbidity were collected using a standardised screening questionnaire. Baseline blood test results were included for a subpopulation (n = 178). Data were analysed using descriptive statistics and logistic regression analysis.

The patients, among whom 83% (n = 334) were women, represented 43 nationalities and had a mean age of 49 years. A total of 19% (n = 78) had no formal schooling. More than 70% (n = 287) reported an (oral and written) interpreter need despite most (63%) having resided in Denmark for > 20 years. Reported symptoms were often pain-related, and 87% (n = 355) reported ≥ 5 symptoms. Multi-morbidity (≥ 2 reported diagnoses) was seen in 73% (n = 298) of the patients. Women had a significantly lower odds ratio (OR) of having > 5 symptoms (OR = 0.44; 95% confidence interval (CI): 0.21-0.92) and an insignificantly lower risk of multi-morbidity (OR = 0.76; 95% CI: 0.40-1.43) than men; no significant differences were seen according to migrant status.

The patients presented with a complex disease burden, language and a disadvantaged socioeconomic status highlighting the need for targeted health services for vulnerable immigrant groups in order to reduce inequities in health.

Department of Infectious Diseases, Hvidovre Hospital.

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