[Perception of difficulties in family medicine in the delivery of health to economic immigrants].
OBJECTIVE
To find the problems, as seen by family doctors, in care for immigrants, with description of proposed solutions.


METHODS
Transversal and descriptive.


METHODS
262 doctors from 18 health centres in a district.


METHODS
Each professional received a questionnaire containing social and demographic variables, number of immigrants seen per day, their place of origin, 6 items on accessibility, 5 on barriers to care, 6 on clinic, and 7 on solutions.


RESULTS
159 doctors, 57.2% women, replied. Average age was 41.1; 64% saw 2-3 immigrants a day. 52.3% (95% CI, 45.0%-61.4%) recognised that care for immigrants posed professional problems. They said that immigrants attended as an emergency more often (81.1%); they more often had no clinical records (74.7%); and they had difficulties obtaining a health card (53%). 67% expressed no difficulties for getting to the hospital. Perceived barriers were the mobility of immigrants (82.9%), language (82.3%), and culture (71.3%). Solutions suggested were translators (95.6%) or cultural intermediary (82.7%). Clinically, doctors saw no differences of pathology in immigrants (56.7%), and no greater psychiatric pathology (66%). Lack of skill in contagious pathologies hampered care (60.3%). 82.8% affirmed that specific protocols were needed. 80.3% argued for a unit of imported diseases. Among care priorities were information on health circuits and making the health card easier to obtain.


CONCLUSIONS
The difficulties sustained by a broad range of professionals are diverse, with access and linguistic-cultural questions standing out. To palliate them, sensitivity from health staff and action from management are needed.
Esteva
M
M
Unidad Docente de Medicina Familiar y Comunitaria, Gerencia Atención Primaria de Mallorca, Baleares, Spain. mesteva@ibsalut.caib.es
Cabrera
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Remartinez
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Díaz
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March
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D000328:Adult; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires