Barriers to Healthcare Access and Utilization Among Immigrants in Host Countries: A Systematic Review of Qualitative and Quantitative Evidence

TL;DR

This review identifies key barriers like language issues, cultural gaps, and discrimination that prevent immigrants from accessing quality healthcare.

Contribution

The study systematically synthesizes both qualitative and quantitative evidence on immigrant healthcare barriers across multiple host countries.

Findings

Limited transcultural competence in healthcare leads to communication issues and reduced care effectiveness.

Language barriers delay care and increase healthcare utilization among immigrant populations.

Discrimination reduces trust in healthcare systems and worsens patient engagement and outcomes.

Abstract

Immigrant populations frequently encounter barriers when accessing healthcare services, potentially affecting patient safety, healthcare utilization, and clinical outcomes. Understanding these barriers is essential for improving equitable and patient-centered care.

A systematic review of qualitative and quantitative studies was conducted in accordance with PRISMA 2020 guidelines. PubMed/MedLINE, Embase, Cochrane Library, PsycINFO, EconLit, Web of Science (WoS), and CINAHL were searched from January 2005 to August 2023. Inductive thematic analysis was used to synthesize findings across studies. The review was not prospectively registered, included only English-language studies, and relied predominantly on qualitative evidence. Heterogeneity across study designs and healthcare settings may limit generalizability. The authors received no external funding for this study.

Three interconnected themes consistently emerged: limited transcultural competence, language barriers, and discrimination in healthcare. Inadequate cultural competence was associated with communication difficulties and reduced care effectiveness. Language barriers contributed to miscommunication, delayed care, and increased healthcare utilization. Experiences of discrimination were linked to reduced trust in healthcare systems and poorer patient engagement. These factors negatively influenced patient safety, satisfaction, and clinical outcomes.

Immigrant patients face persistent and interrelated barriers to healthcare access. Strengthening culturally responsive care, improving access to professional interpreter services, and addressing discriminatory practices are essential to improving patient safety, satisfaction, and clinical outcomes. Future research should evaluate targeted interventions aimed at improving communication, cultural competence, and healthcare equity.

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