title: Poor uptake of primary healthcare registration among recent entrants to the UK: a retrospective cohort study.
abstract: OBJECTIVE
  Uptake of healthcare among migrants is a complex and controversial topic; there are multiple recognised barriers to accessing primary care. Delays in presentation to healthcare services may result in a greater burden on costly emergency care, as well as increased public health risks. This study aimed to explore some of the factors influencing registration of new entrants with general practitioners (GPs).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Port health screening at Heathrow and Gatwick airports, primary care.
  
  
  METHODS
  252 559 new entrants to the UK, whose entry was documented by the port health tuberculosis screening processes at Heathrow and Gatwick. 191 had insufficient information for record linkage.
  
  
  METHODS
  Registration with a GP practice within the UK, as measured through record linkage with the Personal Demographics Service (PDS) database.
  
  
  RESULTS
  Only 32.5% of 252 368 individuals were linked to the PDS, suggesting low levels of registration in the study population. Women were more likely to register than men, with a RR ratio of 1.44 (95% CI 1.41 to 1.46). Compared with those from Europe, individuals of nationalities from the Americas (0.43 (0.39 to 0.47)) and Africa (0.74 (0.69 to 0.79)) were less likely to register. Similarly, students (0.83 (0.81 to 0.85)), long-stay visitors (0.82 (0.77 to 0.87)) and asylum seekers (0.46 (0.42 to 0.51)) were less likely to register with a GP than other migrant groups.
  
  
  CONCLUSIONS
  Levels of registration with GPs within this selected group of new entrants, as measured through record linkage, are low. Migrant groups with the lowest proportion registered are likely to be those with the highest health needs. The UK would benefit from a targeted approach to identify the migrants least likely to register for healthcare and to promote access among both users and service providers.
authors.affiliation: TB Section, Respiratory Diseases Department, Health Protection Services, Health Protection Agency, Colindale, UK.
authors.forename: Helen R
authors.initials: HR
authors.lastname: Stagg
authors.forename: Jane
authors.initials: J
authors.lastname: Jones
authors.forename: Graham
authors.initials: G
authors.lastname: Bickler
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abubakar