Mirza Mansha, Luna Rene, Mathews Bhuttu, Hasnain Rooshey, Hebert Elizabeth, Niebauer Allison, Mishra Uma Devi
Department of Occupational Therapy, College of Applied Health Science, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA,
J Immigr Minor Health. 2014 Aug;16(4):733-42. doi: 10.1007/s10903-013-9906-5.
Chronic conditions and related functional disabilities are highly prevalent among resettled refugees in the United States. There is a need to explore this population's access to appropriate healthcare services in order to identify service disparities and improve interventions. Using a community-based participatory research approach, semi-structured interviews were conducted with key informants to identify healthcare access barriers affecting disabled and chronically ill refugees. Eighteen participants were interviewed, revealing three main barriers: (1) inadequate health insurance, (2) language and communication barriers, and (3) a complex maze of service systems. These barriers were found to operate at systems, provider, and individual levels. Broad-based policy and practice interventions are required to address barriers including: an expanded pool of medical interpreters, peer navigators, innovative health information technologies, and greater collaboration and information-sharing between service systems. Further research is needed to monitor the impact the Affordable Care Act on service access of refugees with disabilities and chronic conditions.
慢性病及相关功能障碍在美国重新安置的难民中极为普遍。有必要探究这一人群获得适当医疗服务的情况,以便识别服务差异并改进干预措施。采用基于社区的参与性研究方法,对关键信息提供者进行了半结构化访谈,以确定影响残疾和慢性病难民获得医疗服务的障碍。采访了18名参与者,揭示了三个主要障碍:(1)医疗保险不足;(2)语言和沟通障碍;(3)复杂的服务系统迷宫。这些障碍在系统、提供者和个人层面都存在。需要采取广泛的政策和实践干预措施来消除障碍,包括:扩大医疗口译员队伍、同伴导航员、创新的健康信息技术,以及服务系统之间加强合作和信息共享。需要进一步研究来监测《平价医疗法案》对残疾和慢性病难民获得服务的影响。