Profiles and pathways of care in situations of vulnerability: what we learn from the journey of refugees and asylum seekers within the refugee clinics (RC) in Quebec

Abstract

Although primary and secondary access to healthcare and services for migrants is considered an essential component of their integration into host societies, their pathways through the health system remain marked by obstacles. However, the migrant population is not a homogeneous group, and the barriers observed in access to care may be exacerbated within certain vulnerable subgroups. This is particularly the case for refugees and asylum seekers.
 As part of this proposal, we benefit from the existence of valuable administrative data (iCLSC) that has informed the progress of refugees and asylum seekers within RC in Quebec since January 1, 2012, to describe and analyze their profiles and service pathways.
 We mainly try to assess to what extent the trajectories observed in the consultations of refugees and asylum seekers (both in terms of healthcare professionals consulted and reasons for consultation) reflect or not the relevance, coherence and adaptation of services and pathways to meet their needs. 
 We mobilize a quantitative approach through three methods of analysis: (i) a descriptive analysis of the profiles of care making it possible to associate the socio-demographic characteristics of refugees and asylum seekers with two indicators of the course of care (healthcare professionals consulted and reasons for consultations); (ii) an analysis of the sequences making it possible to describe and identify the standard profiles of care pathways; (iii) a multinomial regression analysis to identify the factors associated with the different types of pathways.
 Finally, our proposal wishes to answer the question structuring theme 5 of the Conference: How can we reach the most vulnerable groups to ensure an inclusive approach?