Hospitalisation: a comparison among Italians and immigrants enrolled in the cohorts of the Italian network of Longitudinal Metropolitan Studies

BACKGROUND: the foreign population living in Italy is increasing, though at a decreasing rate, and it is urgent to monitor their healthcare service access and their health status in order to fulfil prevention targets and for healthcare planning. OBJECTIVES: to analyse differences in hospitalisation between Italian and foreign citizens aged 1-64 years and residing in six cities participating in the Italian network of the Longitudinal Metropolitan Studies between 2001 and 2013, focusing on foreigners coming from high migratory pressure Countries (HMPC). DESIGN: longitudinal dynamic cohort study. SETTING AND PARTICIPANTS: dynamic cohort of residents in Torino, Venezia, Reggio Emilia, Modena, Bologna, and Roma between 01.01.2001 and 31.12.2013. MAIN OUTCOME MEASURES: the negative binomial regression model was used to estimate age- and calendar-year-adjusted hospitalisation rate ratios for immigrants from HMPC compared to Italians. RESULTS: immigrants from HMPC aged 1-64 years and residing in the cities participating in the study between 2001 and 2013 show a lower hospitalisation compared to their Italian counterpart, in particular if males. Among females, immigrants sometimes show a higher hospitalisation compared to Italians, mainly due to pregnancy and childbirth. Among immigrants, hospitalisation do not decrease over time in some cohorts, while among all cohorts of Italians it always shows decreasing patterns. Excess hospitalisation concerns infectious and blood diseases for both genders, and genitourinary system only among females; proportionally, injury and poisoning represent a critical health area among males. Immigrants from Africa seem to be at a higher risk of hospitalisation. CONCLUSIONS: although overall hospitalisation is lower among immigrants compared to Italians, hospitalisation trends do not seem to decrease over time. The results of this study show excess hospitalisation for some causes and Countries of origin, which deserves specific investigations in order to discover which factors are involved.