Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: an interrupted time series analysis

Zhang, C. X. et al. (2022) Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: an interrupted time series analysis. Lancet Regional Health - Europe, 20, 100455. (doi: 10.1016/j.lanepe.2022.100455) (PMID:35789753) (PMCID:PMC9243519)

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Background: How international migrants access and use primary care in England is poorly understood. We aimed to compare primary care consultation rates between international migrants and non-migrants in England before and during the COVID–19 pandemic (2015–2020). Methods: Using data from the Clinical Practice Research Datalink (CPRD) GOLD, we identified migrants using country-of-birth, visa-status or other codes indicating international migration. We linked CPRD to Office for National Statistics deprivation data and ran a controlled interrupted time series (ITS) using negative binomial regression to compare rates before and during the pandemic. Findings: In 262,644 individuals, pre-pandemic consultation rates per person-year were 4.35 (4.34–4.36) for migrants and 4.60 (4.59–4.60) for non-migrants (RR:0.94 [0.92–0.96]). Between 29 March and 26 December 2020, rates reduced to 3.54 (3.52–3.57) for migrants and 4.2 (4.17–4.23) for non-migrants (RR:0.84 [0.8–0.88]). The first year of the pandemic was associated with a widening of the gap in consultation rates between migrants and non-migrants to 0.89 (95% CI 0.84–0.94) times the ratio before the pandemic. This widening in ratios was greater for children, individuals whose first language was not English, and individuals of White British, White non-British and Black/African/Caribbean/Black British ethnicities. It was also greater in the case of telephone consultations, particularly in London. Interpretation: Migrants were less likely to use primary care than non-migrants before the pandemic and the first year of the pandemic exacerbated this difference. As GP practices retain remote and hybrid models of service delivery, they must improve services and ensure primary care is accessible and responsive to migrants’ healthcare needs. Funding: This study was funded by the Medical Research Council (MC_PC 19070 and MR/V028375/1) and a Wellcome Clinical Research Career Development Fellowship (206602).

Item Type:Articles
Glasgow Author(s) Enlighten ID:Katikireddi, Professor Vittal
Creator Roles:
Katikireddi, S. V.Conceptualization, Methodology, Writing – review and editing, Supervision
Authors: Zhang, C. X., Boukari, Y., Pathak, N., Mathur, R., Katikireddi, S. V., Patel, P., Campos-Matos, I., Lewer, D., Nguyen, V., Hugenholtz, G. C.G., Burns, R., Mulick, A., Henderson, A., and Aldridge, R. W.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Lancet Regional Health - Europe
Publisher:Lancet Publishing Group
ISSN (Online):2666-7762
Published Online:30 June 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Lancet Regional Health - Europe 20: 100455
Publisher Policy:Reproduced under a Creative Commons License
Data DOI:10.5281/zenodo.6345286

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
172690Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiOffice of the Chief Scientific Adviser (CSO)SCAF/15/02SHW - Public Health
3048230021Inequalities in healthAlastair LeylandMedical Research Council (MRC)MC_UU_00022/2HW - MRC/CSO Social and Public Health Sciences Unit
3048230071Inequalities in healthAlastair LeylandOffice of the Chief Scientific Adviser (CSO)SPHSU17HW - MRC/CSO Social and Public Health Sciences Unit