Abstract
BackgroundAlthough a fifth of the German population has a migration background, health research regarding this population is scarce. The few existing studies on migrant health show that migrants are faced with restrictions regarding health care due to communication problems, a lack of information and distinct health literacy. Colorectal cancer (CRC) is the second most common tumor disease in Germany. The aim of the study is to explore the potential differences in patient characteristics between migrants and non-migrants with CRC and identify possible disparities between migrants and non-migrants regarding their satisfaction and perception with health care.MethodsA validated questionnaire was modified for CRC, supplemented with items regarding migration background, translated additionally into Arabic, Turkish and Russian and sent out to 1.694 CRC patients. The outcome indicator was ‘health care satisfaction and experience’ concerning ‘medical consultation’, ‘medical treatment (therapy)’ and ‘hospital stay’ measured on 10-point Likert-scales; explanatory variables were migration background, age, gender, mother tongue, occupation, follow-up care, current discomfort and current treatment. Following descriptive statistics, factor analysis was conducted to compute the outcome variables. Differences between migrants and non-migrants were analyzed using Mann-Whitney-U test and regression analyses.ResultsA total of 522 completed questionnaires – 30.8% response rate – were used for analysis. Patients with a migration background attended less often follow up care than non-migrant patients (74.7% vs. 88.6%; p = 0.001). Mean scores regarding satisfaction and experience with consultation, medical treatment (therapy) and hospital stay were 7.86, 7.11 and 7.51 for migrants and 7.84, 7.19 and 7.33 for non-migrants, measured on a 1 to 10 scale with 10 being most satisfied. Migrants were less satisfied with their own involvement in decision making (p = 0.029) and the aspect “responsiveness to patient’s questions” (p = 0.048) than non-migrants.ConclusionsMigrants showed less compliance with regard to follow-up care than non-migrants. Furthermore, migrants were more often dissatisfied with communication with the medical staff than non-migrants. This shows the importance of (cross-cultural) communication skills on the part of physicians and nurses.
Highlights
A fifth of the German population has a migration background, health research regarding this population is scarce
The majority of the patients were retired by time of diagnosis (67.1% within the German population, 56.2% within the migrant population) and about a fifth was a non-academic employee (18.3% of the non-migrants; 23.3% of the migrants)
Chi2-test showed an association between migration background and ‘compliance to follow up care’ (Chi2 (1) = 10.937, p = 0.001, Cramer’s V = 0.150, CC = 0.149)
Summary
A fifth of the German population has a migration background, health research regarding this population is scarce. Surveys provided evidence that the health of migrants and non-migrants concerning the extent of diseases did not vary that much, except of a few aspects: Typical lifestyle diseases like cardiovascular diseases or cancer, which show a high prevalence in industrial countries, are less frequent within the migrant population. This is explained by healthier dietary habits or the “healthy-migrant-effect” – which is based on the theory that foreign born are in better health than native because only healthy people have the ability to migrate. The smoking prevalence among men and the number of obese women aged 65 years and older is far higher than within the native host-population [2]
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