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Emergency room utilization in Copenhagen: a comparison of immigrant groups and Danish-born residents

Department of Health Services Research, Institute of Public Health, University of Copenhagen

Allan Krasnik

Department of Health Services Research, Institute of Public Health, University of Copenhagen, krasnik{at}pubhealth.ku.dk

Tine Moller Sorensen

Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark

Niels Keiding

Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark

Jette Joost Michaelsen

Department of Health Services Research, Institute of Public Health, University of Copenhagen

Anette Sonne Nielsen

Department of Health Services Research, Institute of Public Health, University of Copenhagen

Background: The aim of the study was to investigate whether utilization of the emergency room differed between immigrant groups and Danish-born residents in Copenhagen, Denmark. Methods: The authors compared the number of emergency room contacts during 1997 among different ethnic groups in the study population. Data were provided by the Statistical Office of the Municipality of Copenhagen. The study population consisted of 183,478 citizens residing in the catchment area of Bispebjerg Hospital in Copenhagen on 1 January 1998. ``Contacts'' included 22,026 visits made to the emergency room at Bispebjerg Hospital during 1997. Both the study population and ``contacts'' were characterized by gender, age, income, and country of birth. The immigrants comprised nine ethnic groups according to country of birth. Data were analysed by Poisson regression comparing rate ratios. Results: Persons born in Somalia, Turkey, and ex-Yugoslavia had higher utilization rates of emergency room than Danish-born residents. All other non-Western-born residents had utilization rates similar to Danish-born residents. Persons born in other Western and European countries showed a tendency towards less utilization. Conclusion: Higher utilization rates among some immigrant groups may be explained by disparities in health or lack of knowledge about the Danish healthcare system as well as barriers to seeking primary care including language, fear of discrimination, and low satisfaction with primary care. The challenge remains to identify these causal relations, and to find out why utilization patterns vary between immigrant groups.

Key Words: immigrants • ethnic minorities • emergency room • healthcare utilization • Denmark • equity

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