Healthcare utilization and satisfaction: a cross-sectional study among Indian immigrants in Japan

Immigration involves adapting to a new country and culture, which can affect well-being. Japan's Indian immigrant population has grown rapidly, highlighting potential gaps in healthcare access. This study examined how acculturation-related factors such as health literacy and social support are associated with healthcare utilization and satisfaction among Indian immigrants in Japan.

This cross-sectional study surveyed Indian immigrants in Japan between October and December 2023. Participants were recruited consecutively at Indian community events across multiple prefectures. Healthcare utilization and satisfaction were measured as primary outcomes using a validated questionnaire. Independent variables included social support (Oslo Scale) and health literacy (BRIEF Scale). Multivariate logistic regression was used to analyze associations.

Of 1,335 individuals approached, 662 responded (50%), and 501 were analyzed (38%; 280 males, 221 females; mean age [SD] 38.9 [7.5] and 36.0 [6.5], respectively). A total of 191 (38%) participants visited outpatient clinics several times a year, 97 (19%) visited dental clinics several times a year, and 415 (83%) received annual health checkups. Long-term immigrants (≥ 11 years) were more likely to utilize maternal services than recent (1-3 years) or mid-term immigrants (4-10 years). Social support showed no significant association with healthcare utilization. Limited health literacy, however, was paradoxically associated with higher satisfaction. Higher satisfaction was also associated with employment/contract status, health insurance coverage, and longer residency in Japan.

Employment status, gender, and residency duration were associated with healthcare patterns among Indian immigrants in Japan. While overall satisfaction was high (75-80%), higher health literacy paradoxically correlated with greater dissatisfaction. Future research should explore interventions to improve healthcare accessibility for recent immigrants.