Abstract
BackgroundAt Doctors of the World Medical Clinic in Stockholm (DWMCS), medical care is offered to migrants who live under particularly vulnerable conditions and who lack access to subsidized care. The demographic, diagnostic and therapeutic panorama of vulnerable migrants is unknown.MethodsA quantitative, retrospective study mapping gender, age, diagnostic group, primary diagnosis, therapeutics, referrals, and session timing (whether the care session took place in summer -April to September, or winter - October to March) by reading all patients’ electronic journals at DWMCS between 2014-04-01 and 2017-12-31. Diagnostic groups were classified according to the classification system ICPC-2 which contains six diagnostic groups: symptoms/complaints, infections, neoplasms, injuries, congenital anomalies and other diagnoses. Primary diagnosis was defined as the diagnosis that was first in the diagnosis list for the visit. Difference in median age was calculated with the Mann-Whitney test (MW), and two-group analysis of nominal data was performed with Monte Carlo simulations (MC) and chi square test´s (X2).ResultsThe study included 1323 patients: 838 women and 485 men. The median age for women 37 years (29-47) was slightly lower than for men, 40 years (31-47) MW (p = 0.002). The largest diagnostic group was symptoms / complaints. The five most common primary diagnoses were cough (4%), back symptom / complaint (4%), cystitis (3%), upper respiratory infection acute (3%) and abdominal pain epigastric (2%). The most common therapeutic (55%) was pharmaceutical. Referrals accounted for 12% of the therapeutics and 25% of the referrals were to an emergency room. Tests of significance indicated an uneven distribution of diagnostic groups MC (p = 0.003), infectious primary diagnoses MC (p = 0.0001) and referrals MC (p = 0.006) between men and women and an uneven seasonal distribution among the Other diagnoses MC (0.04) and ten most common drug treatments MC (p=0.002).ConclusionsThe demographic, diagnostic and therapeutic panorama of vulnerable migrants at DWMCS was elucidated. Vulnerable migrants have differences in morbidity depending on gender and season, differences in therapeutics depending on gender and differences among their most common drug treatments depending on season. This knowledge is important when addressing the health problems of vulnerable migrants.
Highlights
At Doctors of the World Medical Clinic in Stockholm (DWMCS), medical care is offered to migrants who live under vulnerable conditions and who lack access to subsidized care
Vulnerable populations are defined as groups of persons whose range of options is severely limited, who are frequently subjected to coercion in their decision making, or who may be compromised in their ability to Nordenskiöld et al BMC Health Services Research (2022) 22:212 give informed consent [1]
This study offers an insight into the demographic, diagnostic and therapeutic panorama of vulnerable migrants at DWMCS
Summary
At Doctors of the World Medical Clinic in Stockholm (DWMCS), medical care is offered to migrants who live under vulnerable conditions and who lack access to subsidized care. Migrants are by definition people who change their country of usual residence [5]. The term includes people who move between as well as within nations and is independent of whether they move permanently or temporarily [6]. In 2014, more than 200 million migrants moved between countries - more than 3% of the world’s population [7] and in Sweden there were more than 1.6 million migrants born abroad [8]. Migrants often have reduced access to health care due to legal restrictions on access to care, lack of health insurance, insufficient funds to pay fees, cultural misunderstandings, and linguistic problems [9]
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