title: Health care for irregular migrants: pragmatism across Europe: a qualitative study.
abstract: BACKGROUND
  Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in three types of health care service across 16 European countries.
  
  
  RESULTS
  Semi-structured interviews were conducted with health professionals in 144 primary care services, 48 mental health services, and 48 Accident & Emergency departments (total n = 240). Although legal health care entitlement for IM varies across countries, health professionals reported facing similar issues when caring for IM. These issues include access problems, limited communication, and associated legal complications. Differences in the experiences with IM across the three types of services were also explored. Respondents from Accident & Emergency departments reported less of a difference between the care for IM patients and patients in a regular situation than did respondents from primary care and mental health services. Primary care services and mental health services were more concerned with language barriers than Accident & Emergency departments. Notifying the authorities was an uncommon practice, even in countries where health professionals are required to do this.
  
  
  CONCLUSIONS
  The needs of IM patients and the values of the staff appear to be as important as the national legal framework, with staff in different European countries adopting a similar pragmatic approach to delivering health care to IM. While legislation might help to improve health care for IM, more appropriate organisation and local flexibility are equally important, especially for improving access and care pathways.
authors.affiliation: Fonds de la Recherche Scientifique-FNRS, Bruxelles, Belgium. marie.dauvrin@uclouvain.be
authors.forename: Marie
authors.initials: M
authors.lastname: Dauvrin
authors.forename: Vincent
authors.initials: V
authors.lastname: Lorant
authors.forename: Sima
authors.initials: S
authors.lastname: Sandhu
authors.forename: Walter
authors.initials: W
authors.lastname: Devillé
authors.forename: Hamidou
authors.initials: H
authors.lastname: Dia
authors.forename: Sónia
authors.initials: S
authors.lastname: Dias
authors.forename: Andrea
authors.initials: A
authors.lastname: Gaddini
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Ioannidis
authors.forename: Natasja K
authors.initials: NK
authors.lastname: Jensen
authors.forename: Ulrike
authors.initials: U
authors.lastname: Kluge
authors.forename: Ritva
authors.initials: R
authors.lastname: Mertaniemi
authors.forename: Rosa
authors.initials: R
authors.lastname: Puigpinós I Riera
authors.forename: Attila
authors.initials: A
authors.lastname: Sárváry
authors.forename: Christa
authors.initials: C
authors.lastname: Strabmayr
authors.forename: Mindaugas
authors.initials: M
authors.lastname: Stankunas
authors.forename: Joaquim Jf
authors.initials: JJ
authors.lastname: Soares
authors.forename: Marta
authors.initials: M
authors.lastname: Welbel
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D004636:Emergency Service, Hospital / Q000941:ethics / Q000458:organization & administration*; D005060:Europe; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008605:Mental Health Services / Q000941:ethics / Q000458:organization & administration*; D011320:Primary Health Care / Q000941:ethics / Q000458:organization & administration*; D014171:Transients and Migrants / Q000331:legislation & jurisprudence*