The MIGHTY project (P2022ASXKR): demographic and health status profiles among migrants and non-migrants in a region of central Italy between 2011-2023 using Healthcare Utilization Databases

Background Accurate identification of migrants using Healthcare Utilization Databases (HUDs) remains challenging, as citizenship and place of birth may classify residents differently. This study compared two migrant identification criteria and assessed their impact on demographic and health status estimates in an Italian region. Methods A population-based observational study was conducted in the Marche Region (Central Italy), including all residents between 2011 and 2023. The HUDs used were the Regional Beneficiaries Database (RBD), the Hospital Discharge Records, and the Drug Prescriptions Database. Migrants were classified using RBD’s country of birth (RBD birth criterion) and citizenship (RBD citizenship criterion), distinguishing Italians (Ita-Marche), migrants from High Migratory Pressure Countries (HMPC), and from Highly Developed Countries. Agreement between criteria was assessed using Cohen’s k. Health status was evaluated in residents aged ≥50 years using the Multisource Comorbidity Score (MCS). Results Using RBD birth criterion, 88.6% of residents were classified as Ita-Marche, 10.0% as HMPC, and 1.4% as HDC; using RBD citizenship criterion, these proportions shifted to 92.1%, 7.6%, and 0.3%, respectively. Agreement was moderate (k between 0.67-0.70). HMPC residents were notably younger and showed a more favourable health profile: 67% had MCS equal to 0 vs 45% among Ita-Marche, while multimorbidity (MCS ≥5) was lower (9% vs 21.5%). Similar patterns emerged using both criteria. Conclusion Different migrant identification criteria in HUDs lead to variations in population estimates and health indicators. The study provides updated and detailed overview of the demographic structure and comorbidity profiles of Marche’s residents, supporting health policy and service planning.