Use of somatic hospital care services by immigrants in Norway, a retrospective population study

Purpose Across many countries, immigrants underuse specialized care services. Norway has universal health coverage that is mostly free or with only small out of pocket payments. Currently 19.9% of the population are either immigrants or born in Norway to immigrated parents. Earlier Norwegian studies have found underuse of hospital services but using mostly crude measures of activity. The purpose of this paper is to shed new light on the use of health-care services by immigrants in Norway. Design/methodology/approach This paper analyzes health-care utilization of the entire Norwegian population (2016–2017) by exploiting complete national registry data. Statistical regression methods measure the utilization of somatic hospital services at the individual level, to see whether there are associations between immigration variables and the use of services. Findings Immigrants use only about half of the amount hospital care relative to the average population. After controlling for individual characteristics especially age and mortality, utilization for immigrants is still lower than non-immigrants. When the analysis compares patients with other patients (rather than with healthy inhabitants), the differences are even smaller. Originality/value The present study finds clear evidence of underuse among immigrants in Norway for all types of specialized somatic hospital care. A large part of the underuse can be explained by age, mortality and patient status. The remaining causes of underuse are complex and likely to be related to health literacy, cultural issues, language barriers, perceived cost, accessibility and trust.