title: Public health services knowledge and utilization among immigrants in Greece: a cross-sectional study.
abstract: BACKGROUND
  During the 90s, Greece has been transformed to a host country for immigrants mostly from the Balkans and Eastern European Countries, who currently constitute approximately 9% of the total population. Despite the increasing number of the immigrants, little is known about their health status and their accessibility to healthcare services. This study aimed to explore the perceived barriers to access and utilization of healthcare services by immigrants in Greece.
  
  
  METHODS
  A pilot cross-sectional study was conducted from January to April 2012 in Athens, Greece. The study population consisted of 191 immigrants who were living in Greece for less than 10 years. We developed a questionnaire that included information about sociodemographic characteristics, health status, public health services knowledge and utilization and difficulties in health services access. Statistical analysis included Pearson's ×2 test, ×2 test for trend, Student's t-test, analysis of variance and Pearson's correlation coefficient.
  
  
  RESULTS
  Only 20.4% of the participants reported that they had a good/very good degree of knowledge about public health services in Greece. A considerable percentage (62.3%) of the participants needed at least once to use health services but they could not afford it, during the last year, while 49.7% used public health services in the last 12 months in Greece. Among the most important problems were long waiting times in hospitals, difficulties in communication with health professionals and high cost of health care. Increased ability to speak Greek was associated with increased health services knowledge (p<0.001). Increased family monthly income was also associated with less difficulties in accessing health services (p<0.001).
  
  
  CONCLUSIONS
  The empowerment and facilitation of health care access for immigrants in Greece is necessary. Depending on the needs of the migrant population, simple measures such as comprehensive information regarding the available health services and the terms for accessibility is an important step towards enabling better access to needed services.
authors.affiliation: Center for Health Services Management and Evaluation, Faculty of Nursing, University of Athens, Athens, Greece. pegalan@nurs.uoa.gr.
authors.forename: Petros
authors.initials: P
authors.lastname: Galanis
authors.forename: Panayiota
authors.initials: P
authors.lastname: Sourtzi
authors.forename: Thalia
authors.initials: T
authors.lastname: Bellali
authors.forename: Mamas
authors.initials: M
authors.lastname: Theodorou
authors.forename: Ioanna
authors.initials: I
authors.lastname: Karamitri
authors.forename: Olga
authors.initials: O
authors.lastname: Siskou
authors.forename: Giorgos
authors.initials: G
authors.lastname: Charalambous
authors.forename: Daphne
authors.initials: D
authors.lastname: Kaitelidou
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006115:Greece / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
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