1. Charging of overseas visitors in England and universal health coverage: a cross-sectional analysis of NHS trusts
- Author
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Joanna Dobbin, JL Potter, Adrienne Milner, and Alexander Dobbin
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,Freedom of information ,media_common.quotation_subject ,education ,Immigration ,Ethnic group ,social determinants ,migration ,State Medicine ,Young Adult ,Universal Health Insurance ,Health care ,medicine ,Humans ,Social determinants of health ,health care economics and organizations ,media_common ,business.industry ,Public health ,public health ,Public Health, Environmental and Occupational Health ,General Medicine ,humanities ,Cross-Sectional Studies ,England ,Fees and Charges ,Family medicine ,Nationality ,Female ,business - Abstract
Background In 2017, new regulations in England introduced upfront charging for non-urgent care within the National Health Service (NHS). Individuals from outside the European Economic Area who have not paid the immigration surcharge are chargeable for NHS care at 150% of cost. Methods A freedom of information (FOI) request was sent to 135 acute non-specialist NHS trusts in England to create a database of overseas visitors charges. This was analysed using multiple linear regression to explore the relationship between sex, age, nationality, ethnicity, urgency and the cost of healthcare. Results Of 135 acute non-specialist trusts in England 64 replied, providing a data set of 13 484 patients. Women were found to be invoiced higher amounts than men (P = 0.002). Patients were more likely to be women (63 versus 37% men), and within this group, almost half of patients were of reproductive age, with 47.9% (3165) aged 16–40 years old. Only seven trusts supplied data on urgency, and within these trusts the urgency of treatment was significantly related to cost, with the most urgent (immediately necessary) treatment costing the most (P Conclusion This research reflects that that migrant women, and particularly undocumented women, are disproportionately impacted by the NHS charging policies in England.
- Published
- 2020
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