Kennedy Jonathan Donald, Moran Serena, Garrett Sue, Stanley James, Visser Jenny, McKinlay Eileen
Senior Lecturer, Department of Primary Health Care & General Practice, University of Otago; General Practitioner, Newtown Union Health Service, Wellington, New Zealand
Clinical Research Nurse, Department of Primary Health Care & General Practice, University of Otago; Registered Nurse, Newtown Union Health Service, Wellington, New Zealand.
BJGP Open. 2020 May 1;4(1). doi: 10.3399/bjgpopen20X101013. Print 2020.
Refugees and asylum seekers have specific health and social care needs on arrival in a resettlement country. A third group - migrants with a refugee-like background (refugee-like migrants) - are less well defined or understood.
Using routinely collected data, this study compared demographics, interpreter need, and healthcare utilisation for cohorts of refugee-like migrants and refugees.
DESIGN & SETTING: A retrospective cohort study was undertaken in Wellington, New Zealand.
Data were obtained for refugee-like migrants and refugees accepted under the national quota system (quota refugees), who enrolled in a New Zealand primary care practice between 2011 and 2015. Data from the primary care practice and nationally held hospital and outpatient service databases, were analysed. Age and sex standardisation adjusted for possible differences in cohort demographic profiles.
The cohorts were similar in age, sex, deprivation, and interpreter need. Refugee-like migrants were found to have similar, but not identical, health and social care utilisation to quota refugees. Primary care nurse utilisation was higher for refugee-like migrants. Clinical entries in the primary care patient record were similar in rate for the cohorts. Emergency department utilisation and hospital admissions were similar. Hospital outpatient utilisation was lower for refugee-like migrants.
This research suggests that health, social care, and other resettlement services should be aligned for refugee-like migrants and quota refugees. This would mean that countries accepting quota refugees should plan for health and social care needs of subsequent refugee-like migrant family migration. Further research should investigate matched larger-scale national health and immigration datasets, and qualitatively explore factors influencing health-seeking behaviour of refugee-like migrants.
难民和寻求庇护者抵达重新安置国后有特定的健康和社会护理需求。第三类人群——具有类似难民背景的移民（类难民移民）——的定义和了解程度较低。
本研究利用常规收集的数据，比较了类难民移民和难民群体的人口统计学特征、口译需求及医疗保健利用情况。
在新西兰惠灵顿进行了一项回顾性队列研究。
获取了2011年至2015年间在新西兰初级保健机构登记的类难民移民和根据国家配额制度接纳的难民（配额难民）的数据。对初级保健机构以及国家医院和门诊服务数据库的数据进行了分析。年龄和性别标准化对队列人口统计学特征的可能差异进行了调整。
这些队列在年龄、性别、贫困程度和口译需求方面相似。发现类难民移民与配额难民在健康和社会护理利用方面有相似但不完全相同的情况。类难民移民对初级保健护士的利用率更高。初级保健患者记录中的临床记录率在各队列中相似。急诊科利用率和住院情况相似。类难民移民的医院门诊利用率较低。
本研究表明，应使类难民移民和配额难民的健康、社会护理及其他重新安置服务保持一致。这意味着接受配额难民的国家应为后续类难民移民家庭迁移的健康和社会护理需求做好规划。进一步的研究应调查匹配的更大规模的国家健康和移民数据集，并定性探索影响类难民移民求医行为的因素。
