Abstract

Background:According to the U.S. State Department’s Refugee Processing Center and the U.S. Census Bureau, in the fiscal year 2016, among all states in the United States, Nebraska resettled the highest number of refugees per capita.Objectives:The objectives of this study were to determine the most common reasons for refugees utilizing hospital services in Nebraska between January 2011 and September 2015, and to examine whether refugee patients had increased risks for adverse health conditions compared to non-refugee patients.Methods:Statewide linkage was performed between Nebraska Medicaid Program’s immigration data, and 2011–2015 Nebraska hospital discharge data inpatient and outpatient files. The linkage produced 3017, 5460, and 775 cases for emergency department visits, outpatient clinic visits, and inpatient care for the refugee sample, respectively.Findings:Refugee patients were at increased risk for a number of diagnoses or medical conditions, including pregnancy complications, abdominal pain, upper respiratory infections, viral infections, mood disorders, disorders of teeth and jaw, deficiency and anemia, urinary system disorders, headache, nausea and vomiting, limb fractures, spondylosis, essential hypertension, and uncomplicated diabetes mellitus.Conclusions:The findings suggest a greater emphasis on preventive healthcare, especially in areas of maternal health and perinatal outcomes, psychological counseling, screening for infectious diseases, nutrition and healthy eating, and oral health. Additionally, culturally appropriate measures to address prevention, health screening, and treatments should be adopted by health providers who care for refugees.

Highlights

  • The United States has a long history of providing ­protection and assistance to refugees from all over the world

  • There were some studies conducted to understand the patterns of health care utilization among refugee patients, but most of these studies were based on data from a single health care facility [6,7,8]

  • This study found that Nebraska refugee patients were at increased risk for a number of preventable health conditions compared to non-refugee

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Summary

Introduction

The United States has a long history of providing ­protection and assistance to refugees from all over the world. Between 1980 and June of 2017, over 3 million individuals with a refugee background have been resettled in the U.S [2] In spite of this large number of refugees living in the country, there is lack of understanding of health status and health needs of this vulnerable population. After resettlement to the U.S, cultural, language, and financial constraints may prevent people of refugee background from having adequate access to health care [4]. Due to their limited awareness of the need for preventive care [5], refugees may utilize emergency room (ER) or other urgent care more frequently compared to the general population.

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