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Health care provision for illegal immigrants: should public health be concerned?
  1. Alberto M Torresa,
  2. Belén Sanzb
  1. aDepartment of Public Health, Faculty of Medicine, Universidad Miguel Hernandez, Ctra, Alicante-Valencia km 8.7, 03550 San Juan San Juan, Alicante, Spain, bDepartment of International Health, National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
  1. Dr Torres (atorres{at}

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European countries are becoming multicultural societies, and national health systems have progressively adapted following their political and historical peculiarities.1 Overall, sick, immigrants with regularised administrative status are able to use health services in equal terms than people from the host country. Legal immigrants have a poorer health status and worse living conditions than the host population, and consequently, may even have a higher utilisation of health services,2 although that is not always the case.3 Ilegal immigrants are, in principle, not entitled to receive medical care from public services, except in cases of emergencies,4 but it is unclear where and how they receive medical care in cases of need. In some countries “alternative health care providers” such as non-governmental organisations (NGOs) offer medical care, often supported with public funds. But again, we do not know whether those alternative health care providers are used when they exist, and to what extent they are preferred to other providers. The objective of this study was to test whether illegal immigrants are effectively able to obtain medical treatment when ill.


Immigrants from developing countries who resided in one of the Health Areas of the Autonomous Community of Madrid (ACM) (Health Area 6), were older than 15 years of age, and had lived in Spain for more than three months were eligible to enter the study. Our research Area was selected because it had the largest share of immigrants in the ACM. The ACM host about one quarter of the immigrants of Spain, and about one fifth of them lived in our study Area. The southern …

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  • Funding: this study was funded by the Fondo de Investigaciones Sanitarias (Spain) and a Research Fellowship of the Instituto de Salud Carlos III.

  • Conflicts of interest: none.