title: Increased health-care utilisation in international adoptees.
abstract: BACKGROUND
  Several studies have documented that international adoptees have an increased occurrence of health problems and contacts to the health-care system after arriving to their new country of residence. This may be explained by pre-adoption adversities, especially for the period immediately after adoption. Our study aimed to the assess health-care utilisation of international adoptees in primary and secondary care for somatic and psychiatric diagnoses in a late post-adoption period. Is there an increased use of the health-care system in this period, even when increased morbidity in the group of international adoptees is taken into consideration?
  
  
  METHODS
  This was a Danish register-based cohort study examining health-care utilisation in a multivariable two-part model. The prevalence of selected outcomes and the quantity of use were assessed in a late (year three, four and five) post-adoption period. The cohort comprised internationally adopted children (n = 6,820), adopted between 1994 and 2005, and all non-adopted children (n = 492,374) who could be matched with the adopted children on sex, age, municipality and family constellation at the time of adoption.
  
  
  RESULTS
  International adoption increased the use of all services in primary care, while in secondary care only few areas showed an increased long-term morbidity.
  
  
  CONCLUSIONS
  International adoptees use medical services in primary care at a higher rate than non-adoptees some years after adoption. Excess use of services in secondary care is also present, but only exists in selected areas.
  
  
  BACKGROUND
  none.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Department of Public Health, Section of General Practice, Unit of Women and Gender Research in Medicine, University of Copenhagen, P.O. Box 2099, 1014 Copenhagen, Denmark. heidi.graff@sund.ku.dk/heidi.graff@supermail.dk.
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Graff
authors.forename: Volkert D
authors.initials: VD
authors.lastname: Siersma
authors.forename: Jakob
authors.initials: J
authors.lastname: Kragstrup
authors.forename: Birgit
authors.initials: B
authors.lastname: Petersson
mesh_terms: D000300:Adoption; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016555:Matched-Pair Analysis; D001523:Mental Disorders / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data; D063127:Secondary Health Care / Q000706:statistics & numerical data*