Buser S, Brandenberger J, Gmünder M, Pohl C, Ritz N
Migrant Health Service, University of Basel Children's Hospital, Spitalstrasse 33, 4031, Basel, Switzerland.
Pediatric Emergency Department, University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland.
J Immigr Minor Health. 2021 Aug;23(4):669-679. doi: 10.1007/s10903-020-01100-8. Epub 2020 Oct 20.
The aim of this study was to assess the characteristics of asylum-seeking children with medical complexity visiting a tertiary care hospital in Switzerland, detailing their underlying medical conditions and management. Asylum-seeking patients with frequent visits between January 2016 and December 2017 were identified using administrative and electronic health records. Of 462 patients, 19 (4%) fulfilled the inclusion criteria with 811 (45%) visits. The age of the 19 patients ranged from 0 to 16.7 years (median of 7 years) with two main age groups identified: < 2 years and > 12 years. Nine (47%) patients originated from Syria. A total of 34/811(4%) visits were hospital admissions, 66/811 (8%) emergency department visits and 320/811(39%) outpatient department visits. In children < 2 years genetic diseases (5/8; 63%) and nutritional problems (6/8; 75%) were most common; in adolescents, orthopedic diseases (4/8; 50%) and mental health problems (4/8; 50%). Asylum-seeking children with medical complexity represent a small but important group of patients requiring frequent medical consultations. The high proportion of young patients with genetic diseases and severe nutritional problems suggests that new strategies are required in the management of this specific group of asylum-seeking children. This could be achieved by improved co-ordination between hospital and non-hospital care exploring options for integrated care.
本研究的目的是评估在瑞士一家三级护理医院就诊的患有复杂疾病的寻求庇护儿童的特征，详细说明其潜在的医疗状况和治疗情况。利用行政和电子健康记录，确定了2016年1月至2017年12月期间频繁就诊的寻求庇护患者。在462名患者中，19名（4%）符合纳入标准，共就诊811次（45%）。这19名患者的年龄在0至16.7岁之间（中位数为7岁），确定了两个主要年龄组：<2岁和>12岁。9名（47%）患者来自叙利亚。811次就诊中，共有34次（4%）为住院治疗，66次（8%）为急诊科就诊，320次（39%）为门诊就诊。在<2岁的儿童中，遗传疾病（5/8；63%）和营养问题（6/8；75%）最为常见；在青少年中，骨科疾病（4/8；50%）和心理健康问题（4/8；50%）最为常见。患有复杂疾病的寻求庇护儿童是一小群但很重要的患者群体，需要频繁的医疗咨询。患有遗传疾病和严重营养问题的年轻患者比例很高，这表明在管理这一特定群体的寻求庇护儿童时需要新的策略。这可以通过改善医院和非医院护理之间的协调，探索综合护理的选择来实现。
