Medical Care Utilization And Barriers Of Elderly Chinese Immigrants Living In Canada

Backgrounds:The Asian immigrant population is the fastest-growing ethnic group and one of the largest visible minorities in Canada. Elderly Chinese immigrants (over 65 years old) have been one of the largest visible minorities. Due to the differences of culture, language barriers, and the effects of their traditional ideas of elderly Chinese immigrants, their lives in western countries are more easily to be difficult and challenging. New elderly Chinese immigrants in Canada are a large, homogenous, and disadvantaged population. However, research in immigrant health, medical care utilization, and access barriers is not proportional to the size of this population.Objectives:This study aims to describe medical care utilization and the barriers of accessing the medical care systems among elderly new Chinese immigrants, examine the influences of social, economic, and personal factors on medical care utilization and access barriers, and provide a support to improve medical care services and other immigrant research.Methods:A mix method of qualitative and quantitative research is used. Chinese immigrants who are over 65 years old and have lived in the Greater Toronto Area no more than 10 years are invited to participate in Focus group study or questionnaire survey. Five elderly Chinese new immigrants living in the Greater Toronto Area participated in the Focus group interview, and there are 133 eligible questionnaires among 151 participants in the questionnaire surveyResults:The elderly new Chinese immigrants in the survey are high educated, but with poor English level. Over half of senior Chinese new immigrants are living with their children and rely on their financial support. Most of them reported the self-perceived health as good and fair. Medical care utilization, from the highest to the lowest, is 82.17% having a physical check-up,57.94% having an eye examination, and 38.40% having seen a dentist. Mammography for women showed that 67.69% of females have such a screening test. Multiple regression results showed that English ability with a higher level, overweight and obese, male and longer-term immigrants are more easily to use medical care services. Access barriers for elderly new Chinese immigrants are evaluated from two parts. One is for access difficulties, including English communication, transportation, and relying on children to access to the hospital. The other is for satisfaction of medical care including satisfaction on the latest medical service, efficiency, prescription, and contact with doctors in time, and most of the answers are "basically satisfied". After controlling demographic, socio-economic characteristics and chronic diseases, variables of access barriers are not examined to be significant associated with self-perceived health.Conclusion:Medical care utilization among elderly new Chinese immigrants is low and is associated with English level, overweight or obese, and residence time in Canada. "Healthy Immigrant Effect", Chinese traditional opinions of accessing medical care, medical insurance, and knowing medicine-related knowledge could account for part of under-use of medical care service. The main access barriers that elderly new Chinese immigrants are facing included difficulties of accessing medical care and satisfaction of medical services. Difficulties included language barrier, transportation barrier, need accompanied by children, lack of knowledge about diseases, and medical care system in Canada. Satisfaction included low efficiency of medical care system, long waiting time, prescription, and cannot contact with doctors in time. For improving medical care utilization among elderly Chinese immigrants, healthy policy makers should make a significant effort to take into account patient characteristics, help them to know their rights of medical care, and remove the access barriers. Moreover, analyzing and thinking of medical care utilization and access barriers of elderly Chinese immigrants in Canada not only could help to know the medical care system of a developed country, but also could support to improve the medical care for senior citizens in China.