Barriers to healthcare access for irregular immigrants after their arrival in Spain: a systematic review

Examining the barriers encountered by irregular immigrants in accessing the public health system is crucial for the continuity of healthcare processes. This approach not only heightens patient-centered care but also fosters long-term public health preparedness and social cohesion. The aim of this review was to examine the existing barriers to accessing the Spanish healthcare system for the immigrant population. A systematic review of original articles was conducted based on the PRISMA methodology. Studies registered in PubMed, Scopus, CINAHL, LILACS, Web of Science, and Enfispo were analyzed. A total of 4773 articles were identified, of which 15 were selected for review. Among the selected articles, 10 employed qualitative methodologies, 1 utilized a mixed methodology, and 4 used quantitative methodologies. A variety of access barriers related to communication, administrative issues, and misinformation about legal aspects were identified. It was noted that one in five immigrants has experienced at least one barrier to accessing the Spanish healthcare system. Barriers to access to the health system are clearly shared by both immigrants and healthcare professionals. Barriers to access to the health system are a result of the coalition of organizational factors, cultural experiences, and socioeconomic and educational determinants. Access to healthcare for irregular migrants in Spain is hindered by language barriers, misinformation, and administrative obstacles, exacerbated by the COVID-19 pandemic. Policies are needed to ensure equitable care, enhance communication, streamline procedures, and strengthen collaboration with non-governmental organizations and cultural mediators to optimize healthcare responses.