title: Are migrants health policies aimed at improving access to quality healthcare? An analysis of Spanish policies.
abstract: Although until April 2012, all Spanish citizens regardless of their origin, residence status and work situation were entitled to health care, available evidence suggested inadequate access for immigrants. Following the Aday and Andersen model, we conducted an analysis of policy elements that affect immigrants' access to health care in Spain, based on documentary analysis of national policies and selected regional policies related to migrant health care. Selected documents were (a) laws and plans in force at the time containing migrant health policies and (b) evaluations. The analysis included policy principles, objectives, strategies and evaluations. Results show that the national and regional policies analyzed are based on the principle that health care is a right granted to immigrants by law. These policies include strategies to facilitate access to health care, reducing barriers for entry to the system, for example simplifying requirements and raising awareness, but mostly they address the necessary qualities for services to be able to attend to a more diverse population, such as the adaptation of resources and programs, or improved communication and training. However, limited planning was identified in terms of their implementation, necessary resources and evaluation. In conclusion, the policies address relevant barriers of access for migrants and signal improvements in the health system's responsiveness, but reinforcement is required in order for them to be effectively implemented.
authors.affiliation: Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo, 21, 08022 Barcelona, Spain. Electronic address: mlvazquez@consorci.org.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Vázquez
authors.forename: Rebeca
authors.initials: R
authors.lastname: Terraza-Núñez
authors.forename: Silvia
authors.initials: S
authors.lastname: S-Hernández
authors.forename: Ingrid
authors.initials: I
authors.lastname: Vargas
authors.forename: Lola
authors.initials: L
authors.lastname: Bosch
authors.forename: Andrea
authors.initials: A
authors.lastname: González
authors.forename: Sandra
authors.initials: S
authors.lastname: Pequeño
authors.forename: Raquel
authors.initials: R
authors.lastname: Cantos
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Martínez
authors.forename: Luís Andrés
authors.initials: LA
authors.lastname: López
mesh_terms: D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D011787:Quality of Health Care; D013030:Spain; D014171:Transients and Migrants / Q000331:legislation & jurisprudence
keywords: Access; Health care; Immigration; Migrants; Policy analysis; Spain