Abstract
BackgroundThe burden of neuropsychiatric disorders in refugees is likely high, but little has been reported on the neuropsychiatric disorders that affect Syrian and Iraqi refugees in a country of first asylum. This analysis aimed to study the cost and burden of neuropsychiatric disorders among refugees from Syria and Iraq requiring exceptional, United Nations-funded care in a country of first asylum.MethodsThe United Nations High Commissioner for Refugees works with multi-disciplinary, in-country exceptional care committees to review refugees’ applications for emergency or exceptional medical care. Neuropsychiatric diagnoses among refugee applicants were identified through a retrospective review of applications to the Jordanian Exceptional Care Committee (2012–2013). Diagnoses were made using International Classification of Disease-10th edition codes rendered by treating physicians.ResultsNeuropsychiatric applications accounted for 11% (264/2526) of all Exceptional Care Committee applications, representing 223 refugees (40% female; median age 35 years; 57% Syrian, 36% Iraqi, 7% other countries of origin). Two-thirds of neuropsychiatric cases were for emergency care. The total amount requested for neuropsychiatric disorders was 925,674 USD. Syrian refugees were significantly more likely to request neurotrauma care than Iraqis (18/128 vs. 3/80, p = 0.03). The most expensive care per person was for brain tumor (7,905 USD), multiple sclerosis (7,502 USD), and nervous system trauma (6,466 USD), although stroke was the most frequent diagnosis. Schizophrenia was the most costly and frequent diagnosis among the psychiatric disorders (2,269 USD per person, 27,226 USD total).ConclusionsNeuropsychiatric disorders, including those traditionally considered outside the purview of refugee health, are an important burden to health among Iraqi and Syrian refugees. Possible interventions could include stroke risk factor reduction and targeted medication donations for multiple sclerosis, epilepsy, and schizophrenia.Electronic supplementary materialThe online version of this article (doi:10.1186/s13031-015-0038-5) contains supplementary material, which is available to authorized users.
Highlights
The burden of neuropsychiatric disorders in refugees is likely high, but little has been reported on the neuropsychiatric disorders that affect Syrian and Iraqi refugees in a country of first asylum
At the close of 2013, there were 641,915 refugees in the Kingdom of Jordan, including 585,300 Syrian and 20,300 Iraqi refugees assisted by the United Nations High Commissioner of Refugees (UNHCR) [2]
The Exceptional Care Committee Primary and secondary care for refugees in Jordan are provided by government health centers and hospitals as well as through UNHCR partner clinics, using a costsharing model [5]
Summary
The burden of neuropsychiatric disorders in refugees is likely high, but little has been reported on the neuropsychiatric disorders that affect Syrian and Iraqi refugees in a country of first asylum. This analysis aimed to study the cost and burden of neuropsychiatric disorders among refugees from Syria and Iraq requiring exceptional, United Nations-funded care in a country of first asylum. There are limited reported data on neuropsychiatric disorders among Syrian and Iraqi refugees, and existing publications draw primarily on Iraqi populations [3,4]. Neuropsychiatric disorders in displaced populations remain under-studied in countries of first asylum, partly due to the difficulty in gathering clinically informative data during times of humanitarian crises. We analyze the clinical burden and demographic parameters of Syrian and Iraqi refugees requiring
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