title: Utilization of health care services by migrants in Europe-a systematic literature review.
abstract: Our study reviewed the empirical evidence on the utilization of health care services by migrants in Europe, and on differences in health service utilization between migrants and non-migrants across European countries.
  
  
  
  A systematic literature review was performed, searching the databases Medline, Cinahl and Embase and covering the period from January 2009 to April 2016. The final number of articles included was 39.
  
  
  
  Utilization of accident and emergency services and hospitalizations were higher among migrants compared with non-migrants in most countries for which evidence was available. In contrast, screening and outpatient visits for specialized care were generally used less often by migrants.
  
  
  
  Utilization of general practitioner services among migrants compared with non-migrants presents a diverging picture.
  
  
  
  Compared with previous systematic reviews, the results indicate a clearer picture of the differences in health service utilization between migrants and non-migrants in Europe.
  
  
  
  A comprehensive comparison across European countries is impossible because the number of studies is still limited. Further research should also help to identify barriers regarding the utilization of health care services by migrants.
authors.affiliation: Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: V
authors.initials: V
authors.lastname: Graetz
authors.affiliation: European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Rechel
authors.affiliation: Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.|Top Institute Evidence-Based Education Research (TIER), Maastricht University, Maastricht, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Groot
authors.affiliation: Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Norredam
authors.affiliation: Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Pavlova
mesh_terms: D004636:Emergency Service, Hospital / Q000941:ethics / Q000458:organization & administration / Q000706:statistics & numerical data*; D004641:Emigration and Immigration; D005060:Europe / Q000453:epidemiology / Q000208:ethnology; D006302:Health Services Research; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011314:Preventive Health Services / Q000941:ethics / Q000458:organization & administration / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000941:ethics / Q000458:organization & administration / Q000706:statistics & numerical data*; D014171:Transients and Migrants / Q000706:statistics & numerical data; D014600:Utilization Review
keywords: Europe; health care; migrants; service utilization; systematic review