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.

A cohort study on diabetic undocumented migrants in Italy: can charitable organizations contribute to higher adherence? / E. Listorti, A. Torbica, S.G. Cella, G. Fiorini, G. Corrao, M. Franchi. - In: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH. - ISSN 1660-4601. - 20:4(2023 Feb), pp. 2794.1-2794.12. [10.3390/ijerph20042794]

A cohort study on diabetic undocumented migrants in Italy: can charitable organizations contribute to higher adherence?

S.G. Cella
Conceptualization
;
2023

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.
No
English
undocumented migrants; migrants; adherence; diabetes; charitable organizations
Settore BIO/14 - Farmacologia
Settore MED/01 - Statistica Medica
Articolo
Esperti anonimi
Ricerca applicata
Pubblicazione scientifica
Goal 3: Good health and well-being
Goal 10: Reduced inequalities
   Modelling effectiveness, cost-effectiveness and promoting health care value in the real world. The Motive project
   MINISTERO DELL'ISTRUZIONE E DEL MERITO
   2017728JPK_005
feb-2023
MDPI
20
4
2794
1
12
12
Pubblicato
Periodico con rilevanza internazionale
orcid
Aderisco
info:eu-repo/semantics/article
A cohort study on diabetic undocumented migrants in Italy: can charitable organizations contribute to higher adherence? / E. Listorti, A. Torbica, S.G. Cella, G. Fiorini, G. Corrao, M. Franchi. - In: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH. - ISSN 1660-4601. - 20:4(2023 Feb), pp. 2794.1-2794.12. [10.3390/ijerph20042794]
open
Prodotti della ricerca::01 - Articolo su periodico
6
262
Article (author)
Periodico senza Impact Factor
E. Listorti, A. Torbica, S.G. Cella, G. Fiorini, G. Corrao, M. Franchi
File in questo prodotto:
File Dimensione Formato  
19. A Cohort Study on Diabetic Undocumented Migrants in Italy - Can Charitable Organization Contribute to Higher Adherence.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 1.34 MB
Formato Adobe PDF
1.34 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1039492
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 1
  • ???jsp.display-item.citation.isi??? ND
social impact