The perceptions of general practice among Central and Eastern Europeans in the United Kingdom: A systematic scoping review

Transnational Healthcare Practices Among Migrants: A Concept Analysis

AIMS

To present a conceptual definition of transnational healthcare in the context of migrant older adults.

DESIGN

This article follows the Walker and Avant concept analysis framework to conduct an in-depth analysis of transnational healthcare.

METHODS

Databases were searched for scholarly articles using keywords associated with transnational healthcare. The DistillerSR software was employed to screen articles for inclusion in the concept analysis. Titles and abstracts of 390 articles were screened with 50 identified for full-text screening. Thirty-seven articles were included to inform the concept analysis.

DATA SOURCES

Social Science Citation Index (Clarivate), PsycInfo and CINAHL databases. Search dates: March-May 2024.

RESULTS

Defining attributes of the concept include cultural comfort and alignment, perceived quality and trust, integration barriers and experiences of discrimination, use of digital platforms and informal networks, challenges navigating host country health systems. Cases, antecedents, consequences, empirical referents and cultural considerations were used to shape a conceptual definition of transnational healthcare.

CONCLUSION

Transnational healthcare is defined as a practice involving those living outside of their country of origin seeking healthcare from that country of origin through physical or other means.

IMPLICATIONS FOR PROFESSIONAL PRACTICE

This conceptual definition highlights the importance of understanding healthcare access, quality and continuity of care across national borders.

IMPACT

This study addresses gaps in available literature regarding transnational healthcare and its impacts on treatment outcomes, healthcare satisfaction and continuity of care in migrant communities.

REPORTING METHOD

This article adheres to the PRISMA (2020) reporting guidelines for systematic reviews.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Central and Eastern European Migrants in the United Kingdom: A Scoping Review of the Reasons for Utilisation of Transnational Healthcare

BACKGROUND

An estimated 2.2 million people from Central and Eastern Europe (CEE) live in the United Kingdom. It has been documented that CEE migrants underutilise health services in the United Kingdom and, as an alternative, seek healthcare in their home country. However, reasons for seeking healthcare abroad are not always clear. This review aims to identify the reasons for the uptake of transnational healthcare among CEE migrants resident in the United Kingdom.

METHODS

Informed by discussions with community members, medical stakeholders and academics, a systematic scoping review was undertaken following the nine-stage Joanna Briggs Institute framework for scoping reviews. A search strategy with MeSH terms, where relevant, was used and adapted in five academic databases, two grey literature databases and Google Scholar. Included records encompassed four concepts: migration, CEE nationalities, UK nations and healthcare utilisation, which were written in English and published between May 2004 and 2022. Data from the literature were coded, grouped and organised into themes.

RESULTS

A total of 16 publications fulfilled the inclusion criteria. There is evidence that some CEE migrants exclusively use healthcare services in the United Kingdom. However, many CEE migrants utilise healthcare both in the United Kingdom and their country of origin. Four themes were identified from the literature as to why migrants travelled to their country of origin for healthcare: cultural expectations of medical services, distrust in the UK NHS, barriers and transnational ties.

CONCLUSION

Push factors led CEE migrants to seek healthcare in their country of origin, facilitated by ongoing transnational ties. CEE migrants frequently combine visits to their country of origin with medical appointments. Utilising healthcare in their country of origin as opposed to the United Kingdom can result in fragmented and incomplete records of medications, medical tests and surgeries and risk of unnecessary treatments and complications. This review highlights the need for more targeted health outreach with CEE groups within the United Kingdom, as well as the need for further research on the impact of national events, for example, COVID-19 and Brexit, on transnational healthcare-seeking behaviours.

PATIENT OR PUBLIC CONTRIBUTION

The concept for this scoping review was informed by discussions with community members, medical professionals and academics, who identified it as a current issue. The results of this scoping review were discussed with healthcare stakeholders.