Health  Vol.7 No.11 , November 2015
Immigrants’ Satisfaction from the National Health System in Greece: In the Quest of the Contributing Factors
ABSTRACT
Immigrants deserve special attention as they constitute a very sensitive social group, facing an increasing risk of social exclusion. The access of immigrants to health services is one of the most important factors, which contributes to their integration into the society of induction. The purpose of this study is to track and assess the immigrants’ satisfaction from the health services provided by the Greek National Health System (NHS). The satisfaction level assessment is examined in conjunction with demographic and socio-economic characteristics of the study participants, as well as with the characteristics that are related to their personal experience with the National Health System in Greece. The research was conducted from March 2012 to May 2013. The sample of the research comprises of 126 “first-generation” immigrants on legal permit of residence in Greece, who lived in the prefecture of Attica. It is panel study based on “snowball sampling” and the statistical analysis was conducted with the use of the Stata (ver. 11), while the statistical analysis used probit estimation techniques. The demographic and social variables—particularly the variables of gender, “understanding the Greek language”, “education”, “participation in the community of origin” and “insurance”—the variables of “health” and specifically “long-term diseases” and the variable of “trust” are found to be highly related with immigrants’ satisfaction degree from the Greek health system. Our research concludes that health is a fundamental, human right and immigrants’ access to health services is essential not only for their instant and effective treatment of their health problems and the improvement of their lives but also for ensuring the public health in Greece. In order to properly incorporate immigrants in Greece in particular, the health policy decision-makers have to pay attention to the contributing factors.

Cite this paper
Vozikis, A. and Siganou, M. (2015) Immigrants’ Satisfaction from the National Health System in Greece: In the Quest of the Contributing Factors. Health, 7, 1430-1440. doi: 10.4236/health.2015.711157.
References
[1]   Papadaki, G. and Papapdaki, E. (2011) The Policy of Managing Migration Flows towards the European Union and Greece. 9th National Conference of Hellenic Regional Science Association, Panteion University, Athens. (In Greek)

[2]   Hellenic Statistical Authority (EL.STAT.) (2012) Resident Population—Census 2011, EL.STAT., Athens.

[3]   Galanis, P., et al. (2013) Public Health Services Knowledge and Utilization among Immigrants in Greece: A Cross-Sectional Study. BMC Health Services Research, 13, 350
http://dx.doi.org/10.1186/1472-6963-13-350

[4]   Marantou-Alipranti, L. and Gazon, E. (2005) Immigration and Health Care. Assessment of the Current Situation. Challenges and Perspectives. National Center of Social Research—ΕΚΚΕ, Athens.

[5]   Médecins du Monde (2011) Access to Healthcare for Undocumented Migrants in 11 European Countries. Report of the European Observatory, Médecins du Monde, European Observatory on Access to Healthcare, Paris.

[6]   European Commission (2006) Equality in Health: Greek National Report. Edition of Directorate-General for Employment, Social Affairs and Equal Opportunities.

[7]   European Commission (2006) The Demographic Future of Europe—From Challenge to Opportunity, Communication from the Commission, Commission of the European Communities com (2006) 571, Brussels.

[8]   Dixon-Woods, M., Kirk, D., Agarwal, S., Annandale, E., Arthur, T. and Harvey, J. (2005) Vulnerable Groups and Access to Health Care: A Critical Interpretive Review. NCCSDO, London.

[9]   Reijneveld, S.A. (1998) Reported Health, Lifestyles and Use of Health Care of First Generation Immigrants in The Netherlands: Do Socioeconomic Factors Explain Their Adverse Position? Journal of Epidemiology & Community Health, 52, 298-304.

[10]   Stronks, K., Ravelli, A.C.J. and Reijneveld, S.A. (2001) Immigrants in the Netherlands: Equal Access for Equal Needs? Journal of Epidemiology & Community Health, 55, 701-707.

[11]   Uiters, E., Devillé, W., Foets, M. and Groenewegen, P.P. (2006) Use of Health Care Services by Ethnic Minorities in The Netherlands: Do Patterns Differ? European Journal of Public Health, 16, 388-393.

[12]   Hjern, A., Haglund, B., Persson, G. and Rosén, M. (2001) Is There Equity in Access to Health Services for Ethnic Minorities in Sweden? European Journal of Public Health, 11, 147-152.

[13]   Carrasco-Garrido, P., Gil De Miguel, A. and Jiménez-García, R. (2007) Health Profiles, Lifestyles and Use of Health Resources by the Immigrant Population Resident in Spain. European Journal of Public Health, 17, 503-507.

[14]   Cots, F., Castells, X., García, O., Riu, M., Felipe, A. and Vall, O. (2007) Impact of Immigration on the Cost of Emergency Visits in Barcelona (Spain). BMC Health Services Research, 7, 9-21.
http://dx.doi.org/10.1186/1472-6963-7-9

[15]   Donabedian, A. (1988) The Quality of CareHow Can It Be Assessed? The Journal of the American Medical Association, 260, 1743-1748.

[16]   Yucelt, U. (1994) An Invetsigation of Causes of Patient Satisfaction/Dissatisfaction with Physician Services. Health Marketing Quarterly, 12, 11-28.
http://dx.doi.org/10.1300/J026v12n02_03

[17]   Kolter, P. and Clarke, R. (1987) Marketing for Health Care Organisation. Prentice-Hall, Inc., Englewood Cliffs.

[18]   Tselepis, C. (2000) Satisfaction of the Health Service Users, Sociological and Psychological Approach of Hospitals. Health Services, Vol. Α, Hellenic Open University, Patras, 158-164.

[19]   Mirvis, D.M. (1998) Patient Satisfaction: Can Patients Evaluate the Quality of Health Care? Tennessee Medicine, 91, 277-279.

[20]   Mladovsky, P. (2007) Research Note: Migration and Health in the EU. European Commission, Brussels.

[21]   Venema, H.P.U., Garrestsen, H.F.L. and Van der Maas, P.J. (1995) Health of Migrants and Migrants Health Policy. The Netherlands as an Example. Social Science & Medicine, 41, 809-818.
http://dx.doi.org/10.1016/0277-9536(95)00065-F

[22]   Perez, C.E. (2002) Health Status and Health Behaviours among Immigrants. Supplement to Health Reports. Statistics Canada, Ottawa, 1-12.

[23]   Singh, G.K. and Siahpush, M. (2002) Ethnic-Immigrant Differentials in Health Behaviours, Morbidity and Cause-Specific Mortality in the United States. Human Biology, 74, 83-109.
http://dx.doi.org/10.1353/hub.2002.0011

[24]   Muennig, P. and Fahs, M.C. (2002) Health Status and Hospital Utilization of Recent Immigrants to New-York City. Preventive Medicine, 35, 225-231.
http://dx.doi.org/10.1006/pmed.2002.1072

[25]   Leduc, N. and Proux, M. (2004) Patterns of Health Services Utilization by Recent Immigrants. Journal of Immigrant Health, 6, 15-27.
http://dx.doi.org/10.1023/B:JOIH.0000014639.49245.cc

[26]   Khan, S.A. and Ghosh, P. (2005) Medical Needs of Immigrant Populations. BMJ, 331, 418.
http://dx.doi.org/10.1136/bmj.331.7514.418

[27]   Wang, L. (2007) Immigration, Ethnicity and Accessibility to Culturally Diverse Family Physicians. Health & Place, 13, 656-671.
http://dx.doi.org/10.1016/j.healthplace.2006.10.001

[28]   Hargreaves, S., Friedland, J.S., Gothard, P., et al. (2006) Impact on and Use of Health Services by International Migrants: Questionnaire Survey of Inner City London A&E Attenders. BMC health Services Research, 6, 153.
http://dx.doi.org/10.1186/1472-6963-6-153

[29]   Mohanty, S.A., Woolhander, S., Himmelstein, D.U., Pati, S., Carrasquillo, O. and Bor, D.H. (2005) Health Care Expenditures of Immigrants in the United States: A Nationally Representative Analysis. American Journal of Public Health, 95, 1431-1438.
http://dx.doi.org/10.2105/AJPH.2004.044602

[30]   Uiters, E., Devillé, W.L., Foets, M. and Groenewegen, P.P. (2006) Use of Health Care Services by Ethnic Minorities in the Netherlands: Do Patterns Differ? European Journal of Public Health, 16, 388-393.

[31]   Jansa, J.M. and Garcia de Olalla, P. (2004) Health and Immigrations: New Situations and Challenger. Gaceta Sanitaria, 18, 207-213.

[32]   National Quality Forum (2002) Improving Health Care Quality for Minority Patients: Workshop Proceedings. National Forum for Health Care Quality Measurement and Reporting, Washington DC.

[33]   Hall, J.A. and Dornan, M.C. (1988) What Patients Like about Their Medical Care and How Often They Asked: A Meta-Analysis of the Satisfaction Literature. Social Science & Medicine, 27, 935-939.
http://dx.doi.org/10.1016/0277-9536(88)90284-5

[34]   Khayat, K. and Salter, B. (1994) Patient Satisfaction Surveys as s Market Research’ Tool for General Practices. British Journal of General Practice, 44, 215-219.

[35]   Carrasquillo, O., Orav, E.J., Brennan, T.A. and Burstin, H.R. (1999) Impact of Language Barriers on Patient Satisfaction in an Emergency Department. Journal of General Internal Medicine, 14, 82-87.
http://dx.doi.org/10.1046/j.1525-1497.1999.00293.x

[36]   Baker, D.W., Hayes, R. and Fortier, J.P. (1998) Interpreter Use and Satisfaction Interpersonal Aspects of Care for Spanish-Speaking Patients. Medical Care, 36, 1461-1470.
http://dx.doi.org/10.1097/00005650-199810000-00004

[37]   Morales, L.S., Cunningham, W.E., Brown, J.A., Liu, H. and Hays, R.D. (1999) Are Latinos Less Satisfied with Communication by Health Care Providers? Journal of General Internal Medicine, 14, 409-417.

[38]   Kotsioni, I. (2011) Access and Use of Healthcare Services by Migrants. Doctoral Thesis, National and Kapodistrian University of Athens, Medical School, Athens.

[39]   Else, L. (2008) Non-Western Immigrants’ Satisfaction with General Practitioners’ Services in Oslo, Norway. International Journal for Equity in Health, 7, 7.
http://dx.doi.org/10.1186/1475-9276-7-7

[40]   Borde, T., David, M. and Kentenich, H. (2002) What Turkish-Speaking Women Expect in a German Hospital and How Satisfied They Are with Health Care during Their Stay in a Gynaecological Hospital in Berlin. A Comparative Approach. Gesundheitswesen, 64, 476-485.
http://dx.doi.org/10.1055/s-2002-33775

[41]   Ogden, J. and Jain, A. (2005) Patients’ Experiences and Expectations of General Practice: A Questionnaire Study of Differences by Ethnic Group. British Journal of General Practice, 55, 351-356.

[42]   Mygind, A., Norredam, M., Nielsen, A.S., Bagger, J. and Krasnik, A. (2008) The Effect of Patient Origin and Relevance of Contact on Patient and Caregiver Satisfaction in the Emergency Room. Scandinavian Journal of Public Health, 36, 76-83.
http://dx.doi.org/10.1177/1403494807085302

[43]   Taira, D.A., Safran, D.G., Seto, T.B., et al. (1997) Asian-American Patient Ratings of Physician Primary Care Performance. Journal of General Internal Medicine, 12, 237-242.
http://dx.doi.org/10.1007/s11606-006-5046-0

[44]   Dallo, F.J., Borrell, L.N. and Williams, S.L. (2008) Nativity Status and Patient Perceptions of the Patient-Physician Encounter: Results from the Commonwealth Fund 2001 Survey on Disparities in Quality of Health Care. Medical Care, 46, 185-191.
http://dx.doi.org/10.1097/MLR.0b013e318158af29

[45]   Ngo-Metzger, Q., Legedza, A.T. and Phillips, R.S. (2004) Asian Americans’ Reports of Their Health Care Experiences. Results of a National Survey. Journal of General Internal Medicine, 19, 111-119.
http://dx.doi.org/10.1111/j.1525-1497.2004.30143.x

[46]   Small, R., Yelland, J., Lumley, J., Brown, S. and Liamputtong, P. (2002) Immigrant Women’s Views about Care during Labour and Birth: An Australian Study of Vietnamese, Turkish, and Filipino Women. Birth, 29, 266-277.
http://dx.doi.org/10.1046/j.1523-536X.2002.00201.x

[47]   McLachlan, H. and Waldenstrom, U. (2005) Childbirth Experiences in Australia of Women Born in Turkey, Vietnam, and Australia. Birth, 32, 272-282.
http://dx.doi.org/10.1111/j.0730-7659.2005.00370.x

[48]   European Commission (2014) Patient Safety and Quality of Care. Special Eurobarometer 411 Report. European Commission, Directorate-General for Health and Consumers (DG SANCO), Brussels.

[49]   Markova, T., Dean, F. and Neale, A.V. (2007) Health Care Attitudes and Behaviours of Immigrant and US-Born Women in Hamtramck, Michigan: A MetroNet Study. Ethnicity & Disease, 17, 650-656.

[50]   Kambale, J.M. (2010) Migrant Patients’ Satisfaction with Health Care Services: A Comprehensive Review. Italian Journal of Public Health, 7, 69-81.

 
 
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