<p>Migrants’ use of healthcare services is a critical public health issue, often examined through access barriers. In Chile, research has predominantly focused on South–South migration in urban areas. This study extends that focus to a southern Chilean region with lower migration density, exploring how discrimination, satisfaction, and perceived healthcare quality influence healthcare system use among South American migrants. A total of 239 participants (87% Venezuelan, 13% Colombian; mean age = 34.7&#xa0;years) completed online questionnaires across two waves. Perceived discrimination increased from 1.81 to 1.99 (<i>d</i> = –.264), and healthcare system use from 2.46 to 2.60 (<i>d</i> = –.153), while dissatisfaction regarding improvement aspects decreased from 2.60 to 2.41 (<i>d</i> = .262), all <i>ps</i> &lt; .05. Structural equation modelling revealed that discrimination negatively predicted satisfaction with personnel (<i>β</i> = –.264, <i>p</i> &lt; .001), improvement aspects (<i>β</i> = –.195, <i>p</i> &lt; .001), and perceived healthcare quality (<i>β</i> = –.330, <i>p</i> &lt; .001). Perceived quality positively predicted healthcare use (<i>β</i> = .171, <i>p</i> = .014). Discrimination had both a direct (<i>β</i> = .104, <i>p</i> = .012) and an indirect effect (<i>β</i> = –.056, <i>p</i> = .015) on use, mediated by perceived quality. Coefficients ranged from –.330 to .171 showing effect sizes from small to moderate. The model explained 3.2% of the variance in healthcare use. Findings highlight that discrimination in healthcare settings can influence migrants’ engagement with healthcare services, even where formal access is ensured. These results highlight the need for policies targeting interpersonal and perceived quality in migrant healthcare.</p>

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Discrimination, Satisfaction, and use of Public Healthcare Services by South American Migrants in Southern Chile: A Quantitative Study

  • Giuseppe Troccoli,
  • M. J. Rivera-Baeza,
  • D. Manríquez-Robles,
  • C. Salazar-Fernández

摘要

Migrants’ use of healthcare services is a critical public health issue, often examined through access barriers. In Chile, research has predominantly focused on South–South migration in urban areas. This study extends that focus to a southern Chilean region with lower migration density, exploring how discrimination, satisfaction, and perceived healthcare quality influence healthcare system use among South American migrants. A total of 239 participants (87% Venezuelan, 13% Colombian; mean age = 34.7 years) completed online questionnaires across two waves. Perceived discrimination increased from 1.81 to 1.99 (d = –.264), and healthcare system use from 2.46 to 2.60 (d = –.153), while dissatisfaction regarding improvement aspects decreased from 2.60 to 2.41 (d = .262), all ps < .05. Structural equation modelling revealed that discrimination negatively predicted satisfaction with personnel (β = –.264, p < .001), improvement aspects (β = –.195, p < .001), and perceived healthcare quality (β = –.330, p < .001). Perceived quality positively predicted healthcare use (β = .171, p = .014). Discrimination had both a direct (β = .104, p = .012) and an indirect effect (β = –.056, p = .015) on use, mediated by perceived quality. Coefficients ranged from –.330 to .171 showing effect sizes from small to moderate. The model explained 3.2% of the variance in healthcare use. Findings highlight that discrimination in healthcare settings can influence migrants’ engagement with healthcare services, even where formal access is ensured. These results highlight the need for policies targeting interpersonal and perceived quality in migrant healthcare.