SpringerLink
Log in

A Universal Health Care System? Unmet Need for Medical Care Among Regular and Irregular Immigrants in Italy

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

Italy has a universal health care system that covers, in principle, the whole resident population, irrespective of citizenship and legal status. This study calculates the prevalence of unmet need for medical care among Italian citizens, regular and irregular immigrants and estimates logistic regression models to assess whether differences by citizenship and legal status hold true once adjusting for potential confounders. The analysis is based on two Surveys on Income and Living Conditions of Italian households and households with foreigners. Controlling for various factors, the odds of experiencing unmet need for medical care are 27% higher for regular immigrants than for Italian citizens and 59% higher for irregular immigrants. The gaps by citizenship and legal status are even more striking among those with chronic illnesses. These results reveal the high vulnerability of immigrants in Italy and the need to develop more effective policies to achieve health care access for all residents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Source Authors’ analysis based on Istat (2009a) and Istat (2009b)

Fig. 2

Source Authors’ analysis based on Istat (2009a) and Istat (2009b)

Similar content being viewed by others

References

  1. Romero-Ortuno R. Access to health care for illegal immigrants in the EU: should we be concerned? Eur J Health Law. 2004;11:245–72.

    Article  Google Scholar 

  2. European Union. Agency for Fundamental Rights. Migrants in an irregular situation: access to healthcare in 10 European Union Member States. Luxembourg: Publications Office of the European Union; 2011.

    Google Scholar 

  3. Marceca M, Geraci S, Baglio G. Immigrants’ health protection: political, institutional and social perspectives at international and Italian level. Ital J Public Health. 2012;9(3):e7498-1-11.

    Google Scholar 

  4. OECD. Unmet health care needs. Health at a Glance 2014: OECD Indicators. OECD Publishing 2014.

  5. Cavalieri M. Geographical variation of unmet medical needs in Italy: a multivariate logistic regression analysis. Int J Health Geogr. 2013;12:27.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Tognetti M. Health inequalities: access to Services by immigrants in Italy. Open J Soc Sci 2015;3:8.

    Article  Google Scholar 

  7. Tognetti M, Bordogna M, editors. Immigrazione e disuguaglianza di salute. Franco Angeli, Milan 2008.

  8. Nuti S, Maciocco G, Barsani S, editors Immigrazione e salute. Percorsi d’integrazione sociale. Il Mulino, Bologna 2012.

  9. ISTAT. Sanità: Statistiche in breve, Salute e ricorso ai servizi sanitari della popolazione straniera residente in Italia. 11 December 2008.

  10. Giannoni M. Migrants inequalities in unmet need for access to health care in Italy. Paper presented at 15° Aies Conference–Moncalieri (TO) 2010.

  11. Marceca M, Geraci S, Martino A. Esperienza migratoria, salute e disuguaglianze. Osservatorio Italiano sulla Salute Globale—OISG. In: A caro prezzo. Secondo rapporto sulle disuguaglianze. Pisa: VETS; 2006. p. 304–318.

    Google Scholar 

  12. Bianco ML. L’Italia delle disuguaglianze. Rome: Carocci; 2001.

    Google Scholar 

  13. De Luca G, Ponzo M, Andrés AR. Health care utilization by immigrants in Italy. Int J Health Care Finance Econ. 2013;13:1–31.

    Article  PubMed  Google Scholar 

  14. WHO Regional Office for Europe. How health systems can address health inequities linked to migration and ethnicity. Copenhagen: WHO Regional Office; 2010.

    Google Scholar 

  15. Bollini P, Sien H. No real progress towards equity: health of migrants and ethnic minorities on the eve of the year 2000. Soc Sci Med. 1995;41:819–28.

    Article  CAS  PubMed  Google Scholar 

  16. Razum O. Commentary: of salmon and time travellers—musing on the mystery of migration mortality. Int J Epidemiol. 2006;34:919–21.

    Article  Google Scholar 

  17. Razum O, Zeeb H, Rohrmann S. The healthy migrant effect—not merely a fallacy of inaccurate denominator figures. Int J Epidemiol. 2000;29:191–2.

    Article  CAS  PubMed  Google Scholar 

  18. IOM International Organisation for Migration. Migration health: better health for all in Europe. 2009. Final report.

  19. Fernandes A, Miguel JP. Health and migration in the European Union: better health for all in an inclusive society. Lisboa: Instituto Nacional de Saúde Doutor Ricardo Jorge; 2007.

    Google Scholar 

  20. Istat. Survey on Income and Living Conditions (SILC) 2009.

  21. Istat. Survey of Income and Living Conditions of households with foreigners 2009.

  22. Busetta A. Foreigners in Italy: economic living conditions and unmet medical needs. Genus 2016;LXXI(2–3):157–175. ISSN: 2035–5556.

    Google Scholar 

  23. Cylus J, Papanicolas I. An analysis of perceived access to health care in Europe: how universal is universal coverage? Health Policy. 2015;119:1133–44.

    Article  PubMed  Google Scholar 

  24. Koolman X. Unmet need for health care in Europe. Comparative EU statistics on income and living conditions: issues and challenges. Proceedings of the EU-SILC conference. Helsinki: Eurostat; 2007.

  25. Bryant T, Leaver C, Dunn J. Unmet healthcare need, gender, and health inequalities in Canada. Health Policy. 2009;91:24–32.

    Article  PubMed  Google Scholar 

  26. Rustgi SD, Doty MM, Collins SR. Women at risk: why many women are forgoing needed health care. Issue Brief, The Commonwealth Fund 2009.

Download references

Author information

Authors and Affiliations

  1. Department of Economics, Business and Statistics (SEAS), University of Palermo, Viale delle scienze, ed. 13, 90128, Palermo, Italy

    Annalisa Busetta

  2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Valeria Cetorelli

  3. Department of Methodology, London School of Economics, London, UK

    Ben Wilson

  4. Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm University, Stockholm, Sweden

    Ben Wilson

Authors
  1. Annalisa Busetta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Valeria Cetorelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ben Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Annalisa Busetta.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Research Involving Human and Animal Participants

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Busetta, A., Cetorelli, V. & Wilson, B. A Universal Health Care System? Unmet Need for Medical Care Among Regular and Irregular Immigrants in Italy. J Immigrant Minority Health 20, 416–421 (2018). https://doi.org/10.1007/s10903-017-0566-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-017-0566-8

Keywords

Search

Navigation