A latent profile analysis LPA with a subsequent multinomial regression analysis was conducted to characterize the HSU of different groups. Additionally, separate regression models were calculated. Both analyses aimed to estimate the direct effect of migration background on HSU. In separate analyses, general practitioners and medical specialists were used comparably to slightly more often by first-generation migrants from Eastern Europe, Turkey, and resettlers.
Second-generation migrants and migrants from Western countries showed no differences in their HSU compared to non-migrants. This indicates the existence of barriers among those groups that need to be addressed. Migrants are a large and rapidly growing group in many European countries, and they face specific challenges in navigating society, such as orientation in the healthcare system [ 1 ]. First-generation migrants are those with foreign nationality or a foreign country of birth who migrated themselves, while second-generation migrants have at least one foreign or foreign-born parent and have no migration experience of their own.
Although all EU member states recognize the right to the highest possible standard of physical and mental health, inequalities in health service use HSU between migrant and non-migrant populations exist in many European countries and may lead to adverse health outcomes [ 3 β 5 ]. However, general consistent patterns of HSU across countries and different migrant groups can hardly be identified, though an equitable access to health services might be related to a strong primary care system [ 6 , 7 ].
In the most recent systematic review on HSU, which covered results from 10 European countries, general practitioners GPs were more often contacted by migrants than by non-migrants in some studies, while the opposite was observed as well [ 7 , 8 ]. For medical specialists, the majority of studies indicated a lower use of outpatient specialist services by migrants compared to non-migrants. While the use of medical specialists among migrants was higher in the Nordic countries [ 9 , 10 ], in Germany, the Czech Republic, Italy, and Spain a lower HSU was observed [ 8 , 11 β 13 ].
Similarly, a recent systematic review, which included further studies published in German, found a lower use of services by medical specialists and a slightly higher use of services by GPs by migrants compared to non-migrants [ 4 ]. For preventive services, such as oral health check-ups, cancer screening, and mental health services, a consistent pattern of a lower use among migrants compared to non-migrants was observed [ 4 , 5 , 7 ].
