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      [Emergency room services utilization in the province of Reggio Emilia: a comparison between immigrants and Italians].

      Epidemiologia e prevenzione
      Adolescent, Adult, Africa, ethnology, Asia, Child, Child, Preschool, Developing Countries, Diagnosis-Related Groups, Emergency Service, Hospital, utilization, Emigrants and Immigrants, statistics & numerical data, Europe, Eastern, Female, Health Services Accessibility, Health Services Misuse, Health Services Needs and Demand, Health Status Disparities, Humans, Infant, Italy, Male, Middle Aged, Retrospective Studies, Time Factors, Transients and Migrants, Young Adult

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          Abstract

          The aim of the study is to compare Italian and immigrant accesses to Emergency Room (ER) Services in the province of Reggio Emilia, with particular attention to time differences and to potentially inappropriate accesses. the database of ER accesses in the province of Reggio Emilia was analyzed for the years 2007- 2010. In the analysis of the resident population all autochthonous citizens and all immigrants from Developed Countries were considered Italians, while citizens from Developing Countries were Immigrants. Temporary Immigrants were those immigrants with residence and citizenship in a Developing Country. A descriptive analysis was conducted using demographic variables related to patients (age, gender, citizenship and residence) and variables related to access (admission emergency codes, cause of admission, hour, day of the week, month and discharge modality). Standardized access Ratios (SRs) were calculated for the resident population, together with 95%Confidence Intervals (95% CI). The SRs were calculated separately for children and for adults. In the years 2007-2010, 562,658 accesses to ER were recorded for Italians, 95,300 accesses for Immigrants and 6,800 for the Temporary Immigrants. Access rates for resident Immigrants were higher than Italian ones. In 2010, the SR for men was 1.24 (95%CI 1.22-1.27) while for women it was 1.18 (95%CI 1.15-1.27). Considering only non-urgent accesses, the SRs were even higher (SR men=1.65, 95% CI 1.58-1.72, women=1.43, 95% CI 1.36-1.50). Similar findings were observed in children. Immigrants access the ER services more than Italians do.They also show more non-urgent accesses in comparison with Italians. This finding is consistent with results of studies conducted in other European countries and it underlines the necessity to reorganize primary care in order to better meet immigrants' needs.

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