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A Cohort Study on Diabetic Undocumented Migrants in Italy: Can Charitable Organizations Contribute to Higher Adherence?

Author

Listed:
  • Elisabetta Listorti

    (Centre for Healthcare and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi University, 20136 Milan, Italy)

  • Aleksandra Torbica

    (Centre for Healthcare and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi University, 20136 Milan, Italy)

  • Silvano G. Cella

    (Laboratory of Pharmacology and Pharmacoepidemiology, Department of Clinical Sciences and Community Health, University of Milan, Via Vanvitelli 32, 20129 Milan, Italy
    National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy)

  • Gianfrancesco Fiorini

    (Istituti Clinici Zucchi Spa, Medicine, 20900 Monza, Italy)

  • Giovanni Corrao

    (National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy
    Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy)

  • Matteo Franchi

    (National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy
    Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy)

Abstract

The increasing presence of documented and undocumented migrants increases the commitment of the Italian National Health Service to their health needs, following its founding principle of equity. In particular, chronic diseases, such as diabetes, represent a crucial area where patients’ health is affected by their adherence to care pathways, for which the recent literature has reported alarming low levels. In the case of migrants, obstacles to adherence, such as language or organizational barriers, could be overcome thanks also to charitable organizations providing healthcare services. In this study, we aimed to compare the adherence among documented and undocumented migrants who received healthcare services in Milan, Italy, either from the National Health Service (NHS) or from a charitable organization. We identified a cohort of newly taken into care diabetic patients composed of two groups: (i) documented migrants that attend the NHS; and (ii) undocumented migrants that attend a charity. Information was tracked by merging two datasets: the regional healthcare information system of Lombardy, and a unique dataset that collects data on specialistic visits and pharmaceutical prescriptions for all people visiting one of the most prominent charitable organizations in Italy. The annual diabetologist visit was used as the measure of adherence. The probability of being adherent was compared among the two groups by using a multivariate log-binomial regression model, considering a set of personal characteristics that may impact health behaviors. The cohort comprised 6429 subjects. The percentage of adherence was 52% among the documented migrants, and 74% among the undocumented. Regression results confirmed this pattern: undocumented patients have an increased probability of being adherent by 1.19 times (95% CI: 1.12 to 1.26) compared to documented ones. Our study revealed the potentiality of charitable organizations in guaranteeing continuity of care to undocumented migrants. We argue that this mechanism would benefit from central coordination by the government.

Suggested Citation

  • Elisabetta Listorti & Aleksandra Torbica & Silvano G. Cella & Gianfrancesco Fiorini & Giovanni Corrao & Matteo Franchi, 2023. "A Cohort Study on Diabetic Undocumented Migrants in Italy: Can Charitable Organizations Contribute to Higher Adherence?," IJERPH, MDPI, vol. 20(4), pages 1-12, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:4:p:2794-:d:1058073
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    References listed on IDEAS

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    1. Sara Barsanti, 2018. "Hospitalization among migrants in Italy: Access to health care as an opportunity for integration and inclusion," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(3), pages 637-651, July.
    2. Giuseppe Seghieri & Chiara Seghieri & Laura Policardo & Elisa Gualdani & Paolo Francesconi & Fabio Voller, 2019. "Adherence to diabetes care process indicators in migrants as compared to non-migrants with diabetes: a retrospective cohort study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(4), pages 595-601, May.
    3. Elisabetta Listorti & Aleksandra Torbica & Silvano G. Cella & Gianfrancesco Fiorini & Giovanni Corrao & Matteo Franchi, 2022. "Healthcare Services for Undocumented Migrants: Organisation and Costs from the Italian NHS Perspective," IJERPH, MDPI, vol. 19(24), pages 1-10, December.
    4. Gianfrancesco Fiorini & Ivan Cortinovis & Giovanni Corrao & Matteo Franchi & Angela Ida Pincelli & Mario Perotti & Antonello Emilio Rigamonti & Alessandro Sartorio & Silvano Gabriele Cella, 2020. "Current Pharmacological Treatment of Type 2 Diabetes Mellitus in Undocumented Migrants: Is It Appropriate for the Phenotype of the Disease?," IJERPH, MDPI, vol. 17(21), pages 1-15, November.
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    Cited by:

    1. Nikolaos Bountouvis & Eirini Koumpa & Niki Skoutarioti & Dimitrios Kladitis & Aristomenis K. Exadaktylos & Charalampos Anitsakis, 2024. "Burden of Disease in Refugee Patients with Diabetes on the Island of Lesvos—The Experience of a Frontline General Hospital," IJERPH, MDPI, vol. 21(7), pages 1-16, June.

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