A groundbreaking study led by researchers at the Complexity Science Hub (CSH) and the Medical University of Vienna has unveiled striking disparities in hospital utilization patterns among migrant and native populations in Austria. Drawing on an expansive dataset encompassing approximately 13 million inpatient hospital stays of around 4 million individuals from 2015 to 2019, the investigation provides rare quantitative insights into how migration status intersects with healthcare access and outcomes in a European context. While migrants constitute about 20% of Austria’s population, their representation among hospital patients is markedly lower, accounting for just 9.4% of admissions and 9.8% of total hospital nights. These findings posit complex underlying dynamics that challenge prevailing assumptions about migrant health and healthcare engagement.
The overarching phenomenon popularly dubbed the “Healthy Migrant Effect,” whereby migrants are hypothesized to arrive healthier and younger than host populations, has often been invoked to explain lower healthcare utilization among migrants globally. However, this extensive population-level analysis goes beyond simplistic attributions. Through rigorous matching on demographic variables including age, sex, region of residence, and month of hospital visit, the research reveals a nuanced landscape: while migrants generally experience fewer hospital stays, readmission rates within one year are significantly elevated relative to their Austrian counterparts. This paradox suggests that lower hospital utilization may not solely stem from better baseline health but may instead reflect delayed care seeking or access barriers.
Decomposing hospitalization rates by nationality yields heterogeneous patterns. German citizens residing in Austria closely mirror Austrians in their frequency of hospital admissions and diagnostic profiles, likely reflective of linguistic and cultural affinity facilitating healthcare access. Conversely, multiple migrant groups including North Macedonians, Croatians, Serbians, and Russians, exhibit pronouncedly lower hospitalization rates, especially among men. For women, distinct disparities persist: German and Syrian women top hospitalization rates, while Russian and North Macedonian women display substantially lower admission figures. These stratifications underscore the insufficiency of a monolithic migrant category when assessing healthcare utilization and highlight the importance of nationality-specific analyses.
Despite lower hospitalization incidence, migrants exhibit notably higher rates of hospital readmission within a year, with pronounced variance across groups and genders. Among men, Syrians register the highest readmission frequencies, followed by Russian and Afghan men, whereas Hungarian men uniquely demonstrate lower readmission compared to Austrians. Female migrants present a more complex tableau: Afghan women have the highest readmission rates, succeeded by Serbian, German, and Bulgarian women, with North Macedonian women manifesting the lowest. Certain nationalities—Turkish, Italian, Hungarian, Romanian, Croatian, and Bosnian women—also display readmission rates beneath those of Austrian women. These elevated readmission rates potentially reflect delayed initial hospitalization, exacerbated disease progression, or partial access limitations.
The differential readmission trends offer critical clues dissecting the interrelation between migrant health and healthcare accessibility. The persistence of heightened readmissions, even after controlling for age, sex, and geographic region, challenges the exclusive explanatory power of the Healthy Migrant Effect. If superior baseline health were the principal determinant, readmission frequencies would be expected to align or fall below those of the native population. Instead, the divergence suggests that access obstacles—ranging from language barriers and cultural unfamiliarity with healthcare systems to systemic biases—may delay appropriate care utilization until conditions worsen, thereby requiring repeated hospital interventions.
Intriguingly, male migrants consistently experience lower hospitalization rates than female migrants within the same nationality groups. This gendered difference is significantly pronounced among Turkish, German, and Serbian populations, where women exhibit hospital admission rates between 26% and 32% higher than men. Such disparities may reflect sociocultural determinants influencing health-seeking behavior, disease prevalence, or systemic healthcare interactions, indicating the need for gender-sensitive approaches in migrant health policy and research.
Analytical comparisons of hospital admission diagnoses reveal further complexities in migrant healthcare engagement. Non-Austrian patients are less frequently admitted to surgical departments—general and vascular surgery in particular—while displaying higher admission rates to internal medicine specialties including cardiology, nephrology, hematology, oncology, and radiology. This diagnostic distribution suggests a greater burden of chronic or severe illnesses among migrant populations, potentially compounded by delayed initial care seeking. Moreover, psychiatric admissions are comparatively rare among migrants, implying significant underdiagnosis or undertreatment of mental health conditions—an area of growing concern given documented cultural stigma and systemic barriers to mental healthcare among migrant communities.
These empirical nuances lead to an essential conclusion articulated by study co-author Peter Klimek: healthcare utilization among migrant populations cannot be refracted solely through frameworks such as the Healthy Migrant Effect or general access barriers. Instead, patterns diverge substantially between nationality groups, demanding tailored policy interventions. The authors advocate for concerted efforts to enhance outpatient care accessibility, including improved translation services and orientation aids within healthcare institutions, to bridge identified gaps and ensure equitable service delivery.
This comprehensive retrospective cohort study exemplifies the power of data science and multidisciplinary collaboration in unraveling the intricacies of healthcare disparities. By leveraging high-resolution administrative datasets linked with demographic information, it transcends anecdotal evidence and spotlights systemic trends with potential policy ramifications. Findings illuminate the urgency of addressing structural inequities within healthcare systems that affect migrant populations not merely in Austria but across Europe and beyond.
Acknowledging the complexity of healthcare behavior and systemic interfaces, future research avenues may explore longitudinal health outcomes, socio-economic determinants, and intervention efficacy in diverse migrant cohorts. This study’s methodological rigor and scale set a benchmark for such endeavors, marking a pivotal advance in migration and health scholarship.
Ultimately, the research resonates with broader global challenges in health equity, health service delivery, and integration policies amid rising international migration. It underscores the imperative for health systems to adapt dynamically and inclusively, recognizing the heterogeneous needs, risks, and experiences characteristic of migrant subpopulations. Such adaptive responses are crucial to fostering not only health but also social cohesion and sustainability in increasingly diverse societies.
Subject of Research: People
Article Title: Healthcare utilization patterns among migrant populations: Increased readmissions suggest poorer access. A population-wide retrospective cohort study
News Publication Date: 20-Aug-2025
Web References:
https://doi.org/10.1016/j.jmh.2025.100340
https://csh.ac.at/
References:
Dervic, E., Ali, O., Deischinger, C., Prieto-Curiel, R., Stütz, R., Mittendorfer-Rutz, E., & Klimek, P. (2025). Healthcare Utilization Patterns Among Migrant Populations: Increased Readmissions Suggest Poorer Access. A Population-Wide Retrospective Cohort Study. Journal of Migration and Health. https://doi.org/10.1016/j.jmh.2025.100340
Image Credits: © Complexity Science Hub
Keywords: Health care, Health equity, Health care policy, Public health, Health disparity, Medical facilities, Diseases and disorders
