The health care experiences of Travellers compared to the general population: the All-Ireland Traveller Health Study

Objectives: Travellers are a minority population in Ireland and Great Britain, who have poorer health status than the general population. This study aims to investigate Traveller health service utilization and experiences of health service quality. Methods: Community-based census survey of all Traveller households on the island of Ireland in 2008 and 2009. Comparisons were made with survey data from a nationally representative sample of the Irish general public entitled to means-tested general medical services from the INSIGHT '07 survey. Results: Valid responses were provided by 1,947 Traveller respondents (32.5% males). Travellers reported significantly higher use of hospital services including Emergency Room services (sex- and age-adjusted relative risk (RR) 2.37, 95% CI 1.99-2.82) and mental health services (adjusted RR 2.89, 95% CI 2.02-4.14). They described significantly poorer quality health care experiences than did the comparator population, with fewer Travellers expressing trust in caregivers (adjusted RR 0.51, 95% CI 0.47-0.55) and rating the quality of health service they received as being very good or excellent (adjusted RR 0.59, 95% CI 0.55-0.64). After multivariable adjustment for the dimensions of service quality, population (Traveller or INSIGHT '07) was not associated with an overall rating of health service quality. Conclusions: Travellers report greater use of and adequate access to health services, but describe a consistently poorer quality health care experience. This quality gap has implications for Traveller engagement with health care professionals.