title: Hospitalisation for surgical procedures is lower among immigrants than among non-immigrant preschool children: results from a region-wide study in Italy.
abstract: BACKGROUND
  Whether immigrant children receive unnecessary treatments and surgical procedures to a greater extent than non-immigrants remains controversial.
  
  
  OBJECTIVE
  To investigate whether hospitalisation rates differ between immigrant and non-immigrant preschool children and the extent to which such differences relate to specific pathological conditions.
  
  
  METHODS
  All discharges occurring to children aged 1-5 years between 2005 and 2007 in the Italian Region of Veneto (4.8 million inhabitants) were analysed by diagnosis related groups (DRGs). Crude and age-standardised hospitalisation RRs of immigrant versus Italian children were computed. Results Hospitalisation rates for medical conditions were similar between immigrant and Italian children. However, hospitalisation rates among immigrant children were significantly lower than those among Italians for all the most frequent surgical DRGs. RRs (95% CI) of immigrant versus Italian children were 0.46 (0.41 to 0.51) for tonsillectomy/adenoidectomy and 0.46 (0.38 to 0.57) for testes procedures in boys; 0.44 (0.38 to 0.49) for tonsillectomy/adenoidectomy and 0.47 (0.34 to 0.65) for extraocular procedures in girls. Only circumcision procedures were more frequent (fourfold excess) among immigrants.
  
  
  CONCLUSIONS
  Hospitalisation rates for the most frequent surgical procedures are significantly lower among immigrants compared to non-immigrant preschool children. Reduced surgery rates among immigrants might result from a complex interplay between parental attitudes and knowledge of paediatric conditions, language barriers and access to primary care.
authors.affiliation: Epidemiological Department, SER, Veneto Region, Via dei Carpani 16/Z, 31033 Castelfranco Veneto (TV), Italy. frazambon@libero.it
authors.forename: Ugo
authors.initials: U
authors.lastname: Fedeli
authors.forename: Natalia
authors.initials: N
authors.lastname: Alba
authors.forename: Francesco
authors.initials: F
authors.lastname: Zambon
authors.forename: Francesco
authors.initials: F
authors.lastname: Avossa
authors.forename: Paolo
authors.initials: P
authors.lastname: Spolaore
mesh_terms: D000233:Adenoidectomy / Q000706:statistics & numerical data; D002675:Child, Preschool; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007558:Italy; D008297:Male; D012737:Sex Factors; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D014068:Tonsillectomy / Q000706:statistics & numerical data