Health Needs and Access to Healthcare Services in Migrant Populations in Greece: Data From the Hprolipsis Study.

Introduction Migration to Greece continues with a constant influx of immigrants from several countries. The importance and necessity of data related to migrants' health and needs are widely recognized, yet scarce and sporadic. This analysis aims to present data on migrants' health needs and to investigate potential barriers to meeting them. Methods Data were collected during 2013-2016 in the framework of the Hprolipsis study, a health survey in Greece designed to study HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) prevalences in the general population, Roma, and immigrants. Migrants over 18 who had lived in Greece for at least six months were interviewed and, after consent, filled in a specially designed standardized questionnaire. Multivariable logistic models were applied to identify factors associated with unmet health needs. Results In total, 612 migrants participated in the study, (55.6% male, age median 36.9 (interquartile range (IQR) 29.8, 46.4) years, and median stay time 96 (IQR 36.0, 180.0) months. The majority (63.1%) rated their health status as good/very good while 28.3 % reported suffering from a chronic disease. The majority (87.3%) reported health needs during the last 12 months, and a quarter (25.9%) declared unable to meet them. Chronic diseases (adjusted odds ratio (OR): 1.71; 95%CI 1.03, 2.83), poor/very poor health (OR:2.49; (95%CI 1.29, 4.82)), and moderate or severe food insecurity (OR:2.39; 95%CI 1.38, 4.14 and OR 4.03; 95%CI 1.97,8.23, respectively) were identified as aggravating factors for unmet needs. The main reason for unsatisfied health needs was service cost (69.5%) with personal, migrant-status, and social-related reasons representing lower prevalence (27.5%, 21.4%, and 14.5%, respectively). Among those with unmet health needs, age ≥ 40 years (OR=2.66; 95%CI 1.01, 6.97) and unemployment (OR=3.39; 95%CI 1.30, 8.84) were significantly associated with higher odds of reporting economic difficulties while Asian and African origin with significantly lower odds compared to those from the Balkan territory (OR 0.21; 95%CI 0.07, 0.69 and OR 0.25; 95%CI 0.08, 0.82, respectively). Conclusions The more vulnerable migrants (poor/very poor health, chronic disease, and food insecurity) are more likely to be unable to meet their health needs. Health services cost is the most prevalent reason for unmet needs while older age and unemployment increase financial barriers. Expanding access to healthcare for all migrants is required to meet their unmet health needs, in addition to preventive measures aiming to cover basic needs such as food provision, vaccination, and socioeconomic support.