Undocumented immigrants and the experiences of Norwegian general practitioners with this group of patients

Abstract Background: One of the consequences of the increased migration activity is the growth in the number of undocumented immigrants. Many of them end up living in difficult life conditions and require health care. Some, such as war refugees, bring psychological and other traumas with them when arriving at their destination country. During the last decade there has been a growing amount of research in the area of migration and health. However, not many results are available for Scandinavian countries, Norway in particular. More specifically, there exist few research results regarding the phenomenon of undocumented immigrants in Norway, and no results at all concerning the experiences of general practitioners in dealing with this group of patients. Methods: In November 2007, the Norwegian Medical Association, in cooperation with representatives of the municipalities of Oslo, Drammen and Lier, undertook a questionnaire survey of registered and non-registered GPs in the fore mentioned municipalities. The questionnaire was sent for 580 respondents. In total, 215 out of 580 GPs (38%) returned a completed questionnaire. The response rate varied from 34% in Oslo to 56% in Drammen and Lier, and it was 36 % among registered GPs and 47 % among unregistered ones. The data were analyzed by means of frequency tables and contingency tables. Differences between groups were tested by means of Pearson’s chi-square test, a G-test or the Fisher’s exact test. The analyses of the data were performed in Excel and SPSS (Statistical Package for the Social Sciences). Results: GPs that saw more “non-western” patients also saw undocumented immigrants more often; somatic sickness, mental illnesses and infections were the most common problems of undocumented immigrants who contacted GPs; non-registered GPs saw more patients with undocumented immigrant status, than registered GPs did; undocumented immigrants chose to come to particular doctors, because those doctors had been recommended to them by others; there was no association between the perceived level of medical competence and the perceived difficulty to refer patients to higher levels of care; the location of the GPs’ office did not matter for how many undocumented immigrants sought GP’s help; GPs did not receive any payment for their services delivered to undocumented immigrants in one third of the cases, whereas in other cases either the patient himself or the patient’s relative/other person paid for the medical services in full, or the check was sent to the NAV. Interpretation/conclusion: The results of this study indicate that there is a clear need to organize a better access of undocumented immigrants to health care services. That would be in the interest of both the immigrants and society in general