title: Reducing the health care burden for marginalised migrants: The potential role for primary care in Europe.
abstract: There is a growing interest in the health of migrants worldwide. Migrants, particularly those in marginalised situations, face significant barriers and inequities in entitlement and access to high quality health care. This study aimed to explore the potential role of primary care in mitigating such barriers and identify ways in which health care policies and systems can influence the ability of primary care to meet the needs of vulnerable and marginalised migrants. The study compared routinely available country-level data on health system structure and financing, policy support for language and communication, and barriers and facilitators to health care access reported in the published literature. These were then mapped to a framework of primary care systems to identify where the key features mitigating or amplifying barriers to access lay. Reflecting on the data generated, we argue that culturally-sensitive primary care can play a key role in delivering accessible, high-quality care to migrants in vulnerable situations. Policymakers and practitioners need to appreciate that both individual patient capacity, and the way health care systems are configured and funded, can constrain access to care and have a negative impact on the quality of care that practitioners can provide to such populations. Strategies to address these issues, from the level of policy through to practice, are urgently needed.
authors.affiliation: General Practice & Primary Care, Institute of Health & Wellbeing, College of MVLS, University of Glasgow, Glasgow, UK. Electronic address: Kate.O'Donnell@glasgow.ac.uk.
authors.forename: Catherine Agnes
authors.initials: CA
authors.lastname: O'Donnell
authors.affiliation: General Practice & Primary Care, Institute of Health & Wellbeing, College of MVLS, University of Glasgow, Glasgow, UK; Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Burns
authors.affiliation: General Practice & Primary Care, Institute of Health & Wellbeing, College of MVLS, University of Glasgow, Glasgow, UK.
authors.forename: Frances Susanne
authors.initials: FS
authors.lastname: Mair
authors.affiliation: Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Dowrick
authors.affiliation: Pintail Ltd, Dublin, Ireland.
authors.forename: Ciaran
authors.initials: C
authors.lastname: Clissmann
authors.affiliation: Department of Primary Care and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: van den Muijsenbergh
authors.affiliation: Department of Primary Care and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Evelyn
authors.initials: E
authors.lastname: van Weel-Baumgarten
authors.affiliation: Clinic of Social and Family Medicine, University of Crete Medical School, Crete, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
authors.affiliation: Clinic of Social and Family Medicine, University of Crete Medical School, Crete, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Papadakaki
authors.affiliation: Clinic of Social and Family Medicine, University of Crete Medical School, Crete, Greece.
authors.forename: Aristoula
authors.initials: A
authors.lastname: Saridaki
authors.affiliation: National University of Ireland, Galway, Ireland.
authors.forename: Tomas
authors.initials: T
authors.lastname: de Brun
authors.affiliation: Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
authors.forename: Anne
authors.initials: A
authors.lastname: MacFarlane
mesh_terms: D005060:Europe; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D011320:Primary Health Care / Q000706:statistics & numerical data; D036301:Qualitative Research; D011787:Quality of Health Care; D014171:Transients and Migrants
keywords: Entitlement; Equity; Health care policy; Migrant access; Primary care