The profiles and cultures of migrants are becoming more diverse. Despite a policy of universal insurance for migrant workers and asylum seekers, barriers to access to care persist for these groups. This is mainly due to a lack of health services to meet the specific needs of these populations.Patients Migrants
For decades, Switzerland is a country of immigration. For many years, immigrants were mainly manual workers from a small number of European regions underdeveloped. While the legislation continues to severely limit the possibilities of working nationals of non-European countries, the characteristics of migrants today are much more diversified.The manifestations of his globalization are the diversification of the origins of migrant workers, the increase of persons admitted under the asylum and the increase in illegal immigrants. These three categories, separate from the statutory, interwoven in reality.
[...] At the same time, the breakdown of the Soviet bloc and Yugoslavia leads to an increase in refugees from the East. Today, applicants for asylum in Switzerland are of national, cultural, socio-economic levels and diverse religions. The proportion of applicants actually sent is relatively low (Table and number of rejected applicants go into hiding. Illegal Immigrants If the number of illegal immigrants appears to be increasing, there are no statistics on this population. In the experience of health services, this population is largely composed of young women from Latin America, Asia and Eastern Europe. [...]
[...] Fabre The use of hospital emergencies: a mode of access to care for specific populations. Preventing 1st half 1995, no A. Bischoff Oral communication Bovier Chamot Eytan Perneger T. Use of ambulatory mental services among adults in Switzerland. Submitted for publication Bischoff C Tonner, Loutanis Stalder H. Language difficulties in an outpatient clinic in Switzerland. Soz Praventivmed 1999; 44: 283- Rothschild SK. Cross-cultural Issues in primary care medicine. Dis Mon 1998; 44: 239- Bischoff Tonner Eytan Bernstein Loutanis L. Addressing barriers to health care, a survey of medical services in Switzerland. [...]
[...] In the current situation, the economic barriers in access to care are similar for immigrants with legal status and for nationals. Furthermore, data from insurance reported an average cost of care for each asylum seeker than other people, which corresponds to a horizontal real equality in access to care for these group health indicators unfavorable. However, the Swiss political health of asylum seekers, among the most generous of Europe is now questioned. Services Utilization Some studies show an insufficient use of health services by Minorities. [...]
[...] Insecurity and access to care: in Geneva, the hospital out of its walls. Med Hyg 1999, 57: 1825- Simini B. First year results for Bologna's free health care plan. Xavier Bosch. Pregnant illegal immigrants get free health care. (Letters). Lancet 1999; 354: Bollini P. Asylum seekers in Europe: Entitlements, health status and human rights issues. European Journal of Health Law 1997, 235- Cooper Smaje Arber S. Use of health services by children and young people according to ethnicity and social class: Secondary analysis of a national survey. [...]
[...] A competent care of these people made extensive use of low valued skills such as commitment, the ability to question its own values and a curiosity for other cultures. Treating a person with whom it is difficult to request a personal investment in time and from a caregiver, often already overloaded. A sub- optimal23 host could explain the results of a survey of migrant patients awaiting care of "the kindness and understanding".(24) Intolerance is "institutionalized" at the refusal to change work habits to accommodate the demands of the immigrant. [...]
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