IM - ORIGINAL The health of irregular and illegal immigrants: analysis of day-hospital admissions in a department of migration medicine Mario Affronti • Andrea Affronti • Salvatore Pagano • Maurizio Soresi • Lydia Giannitrapani • Miriam Valenti • Emanuele La Spada • Giuseppe Montalto Received: 17 January 2011 / Accepted: 20 May 2011 Ó SIMI 2011 Abstract It is difficult to trace full details of the path which irregular or illegal immigrants follow when seeking assistance in the network of the various hospital depart- ments and health structures. The aim of this work was to analyze the health needs of immigrant people by reviewing the types of treatment given to them in the day-hospital of our Department of Migration Medicine. Our study ana- lyzed day-hospital admissions between 2003 and 2009. The patient charts used for managing day-hospital activity were adopted in 2002 in conformity with the ‘‘OSI project’’. From these it is possible to draw up a scale picture of the distribution of each pathology in the immigrant population. The sample population consisted of 1,758 subjects, repre- senting 7.4% of potential users. More than half came from Africa, followed by Asia, and then Europe. Gastroentero- logical diseases ranked first, with dyspeptic syndromes most frequently diagnosed. Infections and parasitic dis- eases ranked second, and the most frequent diagnoses were sexually transmitted diseases. Third were diseases of the genitourinary system. Metabolic disorders ranked fourth, among them, more than half of the cases were of diabetes mellitus, in patients from south-east Asia. Diseases of the circulatory system were sixth, with hypertension the most frequent pathology. Our data confirm a marked persistence of the phenomenon known as the ‘‘healthy immigrant effect’’ in these types of patients, as well as the prominent role played by ‘‘social determinants’’ in conditioning the health of immigrants, particularly in the case of some infectious diseases. Keywords Health need Á Immigrant people Á Migration diseases Á OSI project Á Risk indicators Introduction In order to establish a correct healthcare approach for immigrants, it is indispensable to analyze and monitor their health needs [1, 2]. However, the data available are not easy to interpret as they are often fragmentary and come from a great number of sources: official registry, office archives, residence permits, social welfare registers, hos- pital discharge files, records of clinical abortions and miscarriages, birth/delivery assistance certificates, com- puterized databases on infectious illnesses, death certifi- cates, data from Inail (Italian National Institute for Insurance against workplace illnesses and injury), etc. The phenomenon of immigration is in itself rather complex and extremely varied, and therefore it is difficult to evaluate in socio-medical terms, not only in consider- ation of the numerous different risk factors in the countries of origin and in the host countries, but also in relation to what services are consequently needed [3]. Official infor- mation sources are not adequately equipped to estimate the true economic conditions of immigrants (education– income–employment status), so it is not possible to detect inequalities in health care access. This inevitably has repercussions on welfare policies, because the political ‘‘visibility’’ of immigrants is proportional to their possi- bility of being included in social welfare programs at all M. Affronti Á A. Affronti Á S. Pagano Á M. Valenti Department of Internal Medicine and Specialties, U.O. di Medicina delle Migrazioni, Palermo, Italy M. Soresi Á L. Giannitrapani Á E. La Spada Á G. Montalto (&) U.O. di Medicina Interna ed Epatologia, Dipartimento di Medicina Interna e Specialistica (DIMIS), University of Palermo, Via del Vespro 141, 90127 Palermo, Italy e-mail: gmontal@unipa.it 123 Intern Emerg Med DOI 10.1007/s11739-011-0635-2