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Showing posts with label Asylum Seekers. Show all posts
Showing posts with label Asylum Seekers. Show all posts
Saturday, April 9, 2016
Thursday, March 3, 2016
Adult Asylum Seekers from the Middle East Including Syria in Central Europe: What Are Their Health Care Problems?
Background
Forced displacement related
to persecution and violent conflict has reached a new peak in recent years. The
primary aim of this study is to provide an initial overview of the acute and
chronic health care problems of asylum seekers from the Middle East, with
special emphasis on asylum seekers from Syria.
Methods
Our retrospective data
analysis comprised adult patients presenting to our emergency department
between 01.11.2011 and 30.06.2014 with the official resident status of an
“asylum seeker” or “refugee” from the Middle East.
Results
In total, 880 patients
were included in the study. Of these, 625 (71.0%) were male and 255 (29.0%)
female. The median age was 34 (range 16–84). 222 (25.2%) of our patients were
from Syria. The most common reason for presentation was surgical (381, 43.3%),
followed by medical (321, 36.5%) and psychiatric (137, 15.6%). In patients with
surgical presentations, trauma-related problems were most common (n = 196,
50.6%). Within the group of patients with medical presentation, acute
infectious diseases were most common (n = 141, 43.9%), followed by neurological
problems (n = 70, 21.8%) and gastrointestinal problems (n = 47, 14.6%). There
were no differences between Syrian and non-Syrian refugees concerning surgical
or medical admissions. The most common chronic disorder of unclear significance
was chronic gastrointestinal problems (n = 132, 15%), followed by chronic
musculoskeletal problems (n = 108, 12.3%) and chronic headaches (n = 78, 8.9%).
Patients from Syria were significantly younger and more often suffered from a
post-traumatic stress disorder than patients of other nationalities
(p<0.0001, and p = 0.05, respectively).
Conclusion
Overall a remarkable
number of our very young group of patients suffered from psychiatric disorders
and unspecified somatic symptoms. Asylum seekers should be carefully evaluated
when presenting to a medical facility and physicians should be aware of the
high incidence of unspecified somatic symptoms in this patient population.In
general, there is no major difference between asylum seekers from Syria when
compared to other nationalities of asylum seekers from the Middle East.
Below: Overview of patients' origins
Below: Number of patients presenting to emergency department by year and country of origin
Below: Overview of psychiatric co-morbidities by country of origin
Full article at: http://goo.gl/b3lkMD
By:
1Department of General Anaesthesiology,
Intensive Care and Pain Management, Medical University of Vienna, Vienna,
Austria
2University Department of Emergency
Medicine, University Hospital and University of Bern, Bern, Switzerland
3University Hospital of Psychiatry and
University of Bern, Bern, Switzerland
Queensland
University of Technology, AUSTRALIA
Competing Interests: The authors have declared that no
competing interests exist.
Conceived and designed the experiments: CAP TM
AKE. Performed the experiments: CAP MS TM BL. Analyzed the data: CAP AKE. Wrote
the paper: CAP MS TM BL AKE.
* E-mail: moc.liamg@relleumtrofpc
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Tuesday, November 24, 2015
Health Literacy & Refugees’ Experiences of the Health Examination for Asylum Seekers – A Swedish Cross-Sectional Study
Background
The
purpose of the health examination for asylum seekers in most countries is to
identify poor health in order to secure the well-being of seekers of asylum and
to guarantee the safety of the population in the host country. Functional
health literacy is an individual’s ability to read information and instructions
about health and to function effectively as a patient in the health system, and
comprehensive health literacy is an individual’s competence in accessing,
understanding, appraising and applying health information. Little is known
about refugees’ health literacy and their experiences of the health examination
for asylum seekers. The purposes of the study were to investigate refugees’
experiences of communication during their health examination for asylum seekers
and the usefulness of that examination, and whether health literacy is
associated with those experiences.
Methods
A
cross-sectional study was made among 360 adult refugees speaking Arabic, Dari,
Somali or English. Health literacy was measured using the Swedish Functional
Health Literacy Scale and the short European Health Literacy Questionnaire.
Experiences of communication and the usefulness of the health examination were
measured in several questions. Associations were sought using univariate and
multivariate statistical models.
Results
In
the health examination for asylum seekers, a poor quality of communication was
experienced by 36 %, receiving little information about health care by
55 %, and receiving little new knowledge by 41 % and/or help by
26 %. Having inadequate as compared to sufficient comprehensive health
literacy was associated with the experience of a poorer quality of
communication (OR: 9.64, CI 95 %: 3.25–28.58) and the experience of
receiving little valuable health care information (OR: 6.54, CI 95 %:
2.45–17.47). Furthermore, having inadequate as compared to sufficient
comprehensive health literacy was associated with the experience of not
receiving new knowledge (OR: 7.94, CI 95 %: 3.00–21.06) or receiving help
with health problems (OR: 8.07, 95 % CI: 2.50–26.07. Functional healthy
literacy was not associated with experiences of HEA.
Conclusion
Refugees’
experiences indicate that a low level of comprehensive health literacy can act
as a barrier to fulfilling the purposes of the health examination for asylum
seekers. Comprehensive health literacy seems to be of greater importance in
that context than functional health literacy.
Full article at: http://goo.gl/hs74c0
1Social Medicine, Department of Public
Health and Caring Science, Uppsala University, Uppsala Science Park, Uppsala,
751 22, Sweden
2Institution of Department of Neuroscience
and Physiology/Occupational Therapy, University of Gothenburg, Göteborg, SE 405
30, Sweden
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Tuesday, November 10, 2015
Equity in Access to Health Care among Asylum Seekers in Germany: Evidence from an Exploratory Population-Based Cross-Sectional Study
Research on inequities in access to health care among
asylum-seekers has focused on disparities between asylum-seekers and resident populations, but
little attention has been paid to potential inequities in access to care within the group of asylum-seekers. We aimed to
analyse the principles of horizontal equity (i.e., equal access for equal need
irrespective of socioeconomic status, SES) and vertical equity (higher
allocation of resources to those with higher need) among asylum-seekers in
Germany.
We performed a secondary exploratory analysis on
cross-sectional data obtained from a population-based questionnaire survey
among all asylum-seekers (aged 18 or above) registered in three administrative
districts in Germany during the three-month study period (N = 1017). Data were collected on
health care access (health care utilisation of four types of services and unmet
medical need), health care need (approximated by sex, age and self-rated health
status), and SES (highest educational attainment and subjective social status,
SSS). We calculated odds ratios and 95 % confidence intervals (CI) in
multiple logistic regression models to analyse associations between SES
indicators and access to health care under control of need.
We contacted 60.4 % (614) of the total asylum-seekers
population, of which 25.4 % (N = 156)
participated in the study. Educational attainment showed no significant effect
on health care access in crude models, but was positively associated with
utilisation of psychotherapists and hospital admissions in adjusted models.
Higher SSS was positively associated with health care utilisation of all types
of services. The odds of hospitals admissions for asylum-seekers in the medium
and highest SSS category were 3.18 times [1.06, 9.59] and 1.6 times [0.49,
5.23] the odds of those in the lowest SSS category. After controlling for need
variables none of the SES indicators were significantly associated with
measures of access to care, but a positive association remained, indicating
higher utilisation of health care among asylum-seekers with higher SES. Age,
sex or general health status were the only significant predictors of health care
utilisation in fully adjusted models. The adjusted odds of reporting unmet
medical needs among asylum-seekers with “fair/bad/very bad” health status were
2.16 times [0.84, 5.59] the odds of those with “good/very good” health status.
Our findings revealed that utilisation of health services
among asylum-seekers is associated with higher need (vertical equity met).
Horizontal equity was met with respect to educational attainment for most
outcomes, but a social gradient in health care utilisation was observed across
SSS. Further confirmatory research is needed, especially on potential
inequities in unmet medical need and on measurements of SES among
asylum-seekers.
Full article at: http://goo.gl/CE12dv
1Department of General Practice & Health
Services Research, University Hospital Heidelberg, Voßstr.2, Geb. 37,
Heidelberg, 69115, Germany
2Institute of General Practice and Interprofessional
Care, University of Tuebingen, Tuebingen, Germany
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