Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany

OBJECTIVES: There are contradictory findings on health care utilization (HCU) of immigrants compared to native-born populations. Our study focuses on this topic using a population-based approach and differentiates generational cohorts of immigrants.

METHODS: In a representative population survey in Germany (N = 2,510), immigrant background/generational cohort and HCU in the preceding 12 months were screened by means of self-rating instruments.

RESULTS: 11.1% (7.0% first and 4.1% second generation) of the sample are immigrants. No differences have been detect with regard to subjective state of health, satisfaction with life and with health and functional disabilities. First generation immigrants contacted a medical specialist less likely, but they more frequently use general practitioners (GPs) than the native-born Germans and the second generation immigrants.

CONCLUSIONS: First generation immigrants show remarkable differences in HCU compared to the native-born Germans and the second generation immigrants. Their HCU seems to be focused on primary care, and access to secondary care might be complicated. It seems relevant to especially pay attention to HCU of first generation immigrants and to support equal access to care for this subgroup.