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Gaceta Sanitaria

Print version ISSN 0213-9111


HERNANDO ARIZALETA, Lauro; PALOMAR RODRIGUEZ, Joaquín; MARQUEZ CID, Mirari  and  MONTEAGUDO PIQUERAS, Olga. Impact of immigration on hospital care: utilization, case-mix, and economic effects. Gac Sanit [online]. 2009, vol.23, n.3, pp.208-215. ISSN 0213-9111.

Objectives: To identify the impact of immigration on health services by comparing hospital discharges, case-mix, and economic effects between immigrants and the native population. Methods: We performed a retrospective longitudinal study of acute-care hospital admissions in Murcia (Spain) registered in the Minimum Data Set from 2004-2005. The groups to be compared, established on the basis of country of birth, were «Spain», «Europe-25» and «remaining countries». Diagnoses were codified using the ICE-9-CM and were grouped by means of the All Patient-Diagnosis Related Groups (AP-DRG) version 18. Utilization rates were calculated by the time of medical insurance. Economic effects were calculated through DRG weights for 2004. Results: There were 196,275 discharges, with 2,590,376 person-years of insurance. The frequency of discharges was 75.8‰ among Spaniards, 64.3‰ among immigrants from Europe-25 and 73.8‰ among immigrants from the remaining countries. The most frequent causes of admission were related to pregnancy, childbirth and the puerperium. Cost per admission was 3,529 € in Spaniards, 3,231 € in persons from Europe-25 and 2,423 € in persons from the remaining countries. The average cost per year of insurance was 263 € for Spaniards, 217 € for immigrants from Europe-25 and 219 € for those from the remaining countries. Conclusions: Hospital utilization and costs per admission and for person-year of insurance are higher in Spaniards than in immigrants, especially the group from «the remaining countries». In this group, case-mix is also different.

Keywords : Case-mix; Hospitalization rates; Immigration; Economic impact; Diagnosis-Related Groups (DRG).

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