Access to health insurance coverage among sub-Saharan African migrants living in France: Results of the ANRS-PARCOURS study

作者：Vignier Nicolas^*; du Lou Annabel Desgrees; Pannetier Julie; Ravalihasy Andrainolo; Gosselin Anne; Lert France; Lydie Nathalie; Bouchaud Olivier; Spira Rosemary Dray

来源：PLos One, 2018, 13(2): e0192916.

DOI：10.1371/journal.pone.0192916

Background
Migrants' access to care depends on their health insurance coverage in the host country. We aimed to evaluate in France the dynamic and the determinants of health insurance coverage acquisition among sub-Saharan migrants.
Methods
In the PARCOURS life-event retrospective survey conducted in 2012-2013 in health-care facilities in the Paris region, data on health insurance coverage (HIC) each year since arrival in France has been collected among three groups of sub-Saharan migrants recruited in primary care centres (N = 763), centres for HIV care (N = 923) and for chronic hepatitis B care (N = 778). Year to year, the determinants of the acquisition and lapse of HIC were analysed with mixed-effects logistic regression models.
Results
In the year of arrival, 63.4% of women and 55.3% of men obtained HIC. But three years after arrival, still 14% of women and 19% of men had not obtained HIC. HIC acquisition was accelerated in case of HIV or hepatitis B infection, for migrants arrived after 2000, and for women in case of pregnancy and when they were studying. Conversely, it was slowed down in case of lack of a residency permit and lack of financial resources for men. In addition, women and men without residency permits were more likely to have lost HIC when they had one.
Conclusion
In France, the health insurance system aiming at protecting all, including undocumented migrants, leads to a prompt access to HIC for migrants from sub-Saharan Africa. Nevertheless, this access may be impaired by administrative and social insecurities.

• 出版日期2018-2-15