Hospitalization among natives and migrants. The case of Lombardy, 2010-2019

Abstract

The usage patterns of healthcare services differ significantly between the native and migrant populations. Using the administrative health database of the Lombardy Region, we compared the hospitalization rates of natives and migrants from 2010 to 2019. Migrants were categorized into two groups: those from countries with high emigration rates (HMPC) and those from other countries (HDC). Standardized hospitalization rates decreased between 2010 and 2019 for both men and women across all groups (Italians, HMPC migrants, and HDC migrants). Women exhibited higher hospitalization rates compared to men due to childbirth and pregnancy-related complications. Among women, HMPC migrants had the highest standardized hospitalization rates throughout the study period, though the gap with natives has recently narrowed. Among men, HMPC migrants had the lowest standardized hospitalization rates, with the disparity between natives and migrants remaining consistent over time. Poisson and negative binomial regression models were used to analyse the crude hospitalization rate as the dependent variable to highlight the differences among geographic groups and sex across years. Age plays a key role, with younger women and those under childbearing age showing lower hospitalization rates. Additionally, we calculated crude and standardised rates for avoidable hospitalization and access to the Emergency Department.