Healthcare utilization among children with immigrant parents in Spain: a matched cross-sectional study using data from the Spanish National Health Survey 2023

Children with immigrant parents represent a growing population group in Spain, yet national evidence regarding their use of healthcare services remains limited. This study aimed to assess differences in healthcare utilization between children with immigrant parents and matched children with native-born parents using data from the Spanish National Health Survey 2023 (SNHS2023). A population-based cross-sectional study was conducted using data from the child questionnaire of the SNHS2023. Children aged 0–14 years whose mother and father were both born outside Spain were classified as children with immigrant parents and matched 1:1 by age, sex, and autonomous community of residence with children whose parents were both born in Spain. The final sample included 1,320 children (660 per group). Outcomes included primary care visits, specialist consultations, psychologist visits, dentist visits, emergency room visits, and hospital admissions during the previous 12 months. Conditional logistic regression models were used to estimate adjusted odds ratios (OR) and 95% confidence intervals (95% CI). Children with immigrant parents had lower household income, lower parental educational attainment, lower private health insurance coverage, lower physical activity levels, higher screen use, and a higher prevalence of obesity. No differences were observed in self-rated health or chronic conditions. Children with immigrant parents showed lower use of specialist consultations (30.3% vs. 44.8%), psychologist visits (4.4% vs. 10.0%), and dental services (39.7% vs. 57.6%) (all p < 0.001). No differences were found in primary care visits, emergency room visits, or hospital admissions. In fully adjusted models, children with native-born parents had higher odds of specialist consultations (OR 1.40; 95% CI 1.03–1.98), psychologist visits (OR 1.98; 95% CI 1.01–3.89), and dental visits (OR 1.48; 95% CI 1.01–2.19). These results were confirmed after missing data sensitivity analysis using multiple imputations. Children with immigrant parents in Spain experience less favorable socioeconomic and lifestyle conditions and lower utilization of specialist, psychological, and dental healthcare services. These findings suggest persistent inequalities in healthcare utilization and support the need for interventions aimed at improving healthcare equity among families with immigrant parents.