Evans Andrea, Caudarella Alexander, Ratnapalan Savithiri, Chan Kevin
Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Department of Family Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2014 May 8;9(5):e96902. doi: 10.1371/journal.pone.0096902. eCollection 2014.
On June 30, 2012, Interim Federal Health Program (IFHP) funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown.
We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross.
There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (p<0.001).
After the cuts to the IFHP, The Hospital for Sick Children was unable to obtain federal health coverage for the vast majority of refugee claimant children registered under the IFHP. This preliminary analysis showed that post-IFHP cuts healthcare costs at the largest tertiary pediatric institution in the country increased.
2012年6月30日,联邦临时健康计划(IFHP)对难民申请人体检的资金投入被削减。这些削减对难民申请人可能产生的经济和医疗影响尚不清楚。
我们对多伦多一家三级儿童专科医院——病童医院IFHP资金削减前后6个月进行了为期一年的回顾性病历审查。我们分析了急诊就诊特征、住院率、住院原因以及包括Medavie Blue Cross账单在内的财务记录。
资金削减前六个月有173名难民儿童到急诊室就诊,削减后六个月有142名。在本研究的一年中,向IFHP计划开具的账单总额为131,615美元。在IFHP削减之前,急诊室账单总额的46%由IFHP支付,削减后这一比例为7%(p<0.001)。
IFHP削减后,病童医院无法为绝大多数在IFHP登记的难民申请儿童获得联邦医保。这一初步分析表明,在该国最大的三级儿科机构,IFHP削减后医疗成本增加。