A Cohort Study on Diabetic Undocumented Migrants in Italy: Can Charitable Organizations Contribute to Higher Adherence?-Reference-Cited by-同舟云学术

A Cohort Study on Diabetic Undocumented Migrants in Italy: Can Charitable Organizations Contribute to Higher Adherence?

Published:2023-02-04 Issue:4 Volume:20 Page:2794
ISSN:1660-4601
Container-title:International Journal of Environmental Research and Public Health
language:en
Short-container-title:IJERPH

Author:

Listorti Elisabetta¹^ORCID,Torbica Aleksandra¹,Cella Silvano G.²³^ORCID,Fiorini Gianfrancesco⁴,Corrao Giovanni³⁵^ORCID,Franchi Matteo³⁵^ORCID

Affiliation:

1. Centre for Healthcare and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi University, 20136 Milan, Italy

2. Laboratory of Pharmacology and Pharmacoepidemiology, Department of Clinical Sciences and Community Health, University of Milan, Via Vanvitelli 32, 20129 Milan, Italy

3. National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy

4. Istituti Clinici Zucchi Spa, Medicine, 20900 Monza, Italy

5. Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy

Abstract

The increasing presence of documented and undocumented migrants increases the commitment of the Italian National Health Service to their health needs, following its founding principle of equity. In particular, chronic diseases, such as diabetes, represent a crucial area where patients’ health is affected by their adherence to care pathways, for which the recent literature has reported alarming low levels. In the case of migrants, obstacles to adherence, such as language or organizational barriers, could be overcome thanks also to charitable organizations providing healthcare services. In this study, we aimed to compare the adherence among documented and undocumented migrants who received healthcare services in Milan, Italy, either from the National Health Service (NHS) or from a charitable organization. We identified a cohort of newly taken into care diabetic patients composed of two groups: (i) documented migrants that attend the NHS; and (ii) undocumented migrants that attend a charity. Information was tracked by merging two datasets: the regional healthcare information system of Lombardy, and a unique dataset that collects data on specialistic visits and pharmaceutical prescriptions for all people visiting one of the most prominent charitable organizations in Italy. The annual diabetologist visit was used as the measure of adherence. The probability of being adherent was compared among the two groups by using a multivariate log-binomial regression model, considering a set of personal characteristics that may impact health behaviors. The cohort comprised 6429 subjects. The percentage of adherence was 52% among the documented migrants, and 74% among the undocumented. Regression results confirmed this pattern: undocumented patients have an increased probability of being adherent by 1.19 times (95% CI: 1.12 to 1.26) compared to documented ones. Our study revealed the potentiality of charitable organizations in guaranteeing continuity of care to undocumented migrants. We argue that this mechanism would benefit from central coordination by the government.

Funder

Italian Ministry of Education, University and Research

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

Link

https://www.mdpi.com/1660-4601/20/4/2794/pdf

Reference40 articles.

1. Mcauliffe, M., and Triandafyllidou, A. (2021). World Migration Report 22, International Organization for Migration (IOM).

2. Cesareo, V. (2021). The Twenty-Sixth Italian Report on Migrations 2020, Fondazione ISMU.

3. Towards universal health coverage: Including undocumented migrants;Onarheim;BMJ Glob. Health,2018

4. National Legislative Bodies (1998). Legislative Decree 286/98, art. 35, Paragraph 3, National Legislative Bodies.

5. De Vito, E., De Waure, C., Specchia, M.L., and Ricciardi, W. (2015). Public Health Aspects of Migrant Health: A Review of the Evidence on Health Status for Undocumented Migrants in the European Region, World Health Organization. Regional Office for Europe.