Department of Pediatrics, Rijnstate Hospital, Wagnerlaan 55, 6816 AD, Arnhem, The Netherlands.
Department of Pediatrics, VU University Medical Center and Emma Children's Hospital - Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Eur J Pediatr. 2018 Jul;177(7):995-1002. doi: 10.1007/s00431-018-3141-y. Epub 2018 Apr 20.
Pediatricians in the Netherlands have been confronted with high numbers of refugee children in their daily practice. Refugee children have been recognized as an at-risk population because they may have an increased burden of physical and mental health conditions, and their caretakers may experience barriers in gaining access to the Dutch health care system. The aim of the study was to gain insight into the barriers in the health care for refugee children perceived by pediatricians by analyzing logistical problems reported through the Dutch Pediatric Surveillance Unit, an online system where pediatricians can report predefined conditions. Pediatricians reported 68 cases of barriers in health care ranging from mild to severe impact on the health outcome of refugee children, reported from November 2015 till January 2017. Frequent relocation of children between asylum seeker centers was mentioned in 28 of the reports on lack of continuity of care. Unknown medical history (21/68) and poor handoffs of medical records resulting in poor communication between health professionals (17/68) contributed to barriers to provide good medical care for refugee children, as did poor health literacy (17/68) and cultural differences (5/68).
Frequent relocations and the unknown medical history were reported most frequently as barriers impacting the delivery of health care to refugee children. To overcome these barriers, the Committee of International Child Health of the Dutch Society of Pediatrics recommends stopping the frequent relocations, improving medical assessment upon entry in the Netherlands, improving handoff of medical records, and improving the health literacy of refugee children and their families. What is Known: • Pediatricians in the Netherlands are confronted with high numbers of refugee children • Refugee children represent a population that is especially at risk due to their increased burden of physical and mental health conditions What is New: • Refugee children experience barriers in accessing medical care • To start overcoming these barriers, we recommend that frequent relocations be stopped, health assessment upon entry in the Netherlands be improved, medical handoffs be improved, and that the refugees be empowered by increasing their health literacy.
荷兰的儿科医生在日常工作中经常会遇到大量的难民儿童。难民儿童被认为是一个处于危险之中的群体，因为他们可能面临更多的身心健康问题，而且他们的照顾者在获得荷兰医疗保健系统方面可能会遇到障碍。本研究旨在通过分析荷兰儿科监测单位报告的后勤问题，了解儿科医生认为难民儿童医疗保健中存在的障碍，荷兰儿科监测单位是一个在线系统，儿科医生可以在该系统中报告预定义的疾病。
儿科医生报告了 68 例医疗保健障碍，这些障碍对难民儿童的健康结果造成了从轻度到重度的影响，报告时间为 2015 年 11 月至 2017 年 1 月。28 份报告提到难民儿童在庇护所之间频繁搬迁，导致护理连续性缺失。有 21/68 例难民儿童的医疗记录不详，17/68 例医疗记录交接不善，导致卫生专业人员之间沟通不畅，这也导致了难民儿童获得良好医疗服务的障碍，难民儿童的健康素养差（17/68）和文化差异（5/68）也是障碍之一。
频繁搬迁和医疗记录不详是报告中最常提到的影响难民儿童医疗服务提供的障碍。为了克服这些障碍，荷兰儿科学会国际儿童健康委员会建议停止难民儿童的频繁搬迁，改善进入荷兰时的医疗评估，改善医疗记录交接，并提高难民儿童及其家庭的健康素养。
