Phaiyarom Mathudara, Kosiyaporn Hathairat, Pudpong Nareerut, Sinam Pigunkaew, Suphanchaimat Rapeepong, Julchoo Sataporn, Kunpeuk Watinee
International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand.
Sirindron College of Public Health, Chonburi, Thailand.
Risk Manag Healthc Policy. 2021 Aug 17;14:3423-3433. doi: 10.2147/RMHP.S314090. eCollection 2021.
The health of urban refugees and asylum seekers (URAS) in Thailand has been under-researched compared with other groups of non-Thai populations, especially in the area of chronic non-communicable diseases (NCD). The objectives of this study were to i) examine NCD prevalence; ii) access to NCD services; and iii) factors associated with access to NCD services among urban refugees and asylum seekers (URAS) in comparison with the Thai population.
A cross-sectional study, using a self-administrative questionnaire adapted from the Thai Health and Welfare Survey (HWS), was conducted in 2019. URAS were randomly selected from the register of the Bangkok Refugee Center. One hundred and eighty-one URAS participated in the survey. The data were combined with 2941 Thai records from the HWS. The population scope was confined to Bangkok. Bivariate analysis by Chi-square, Fisher's exact, and Mann-Whitney -tests was conducted to examine difference in demographic and access to NCD services between URAS and Thais. Multivariable logistic regression was performed to identify factors associated with access to NCD services.
Overall, URAS were young, less educated, and poorer than Thais. The trend of NCDs was similar to the Thai population, except mental health disorders appeared to be more prevalent in URAS. Almost half of the URAS did not receive any formal treatment. Being insured, abiding with Buddhism, and living in more affluent households were factors associated with better access to NCD services. URAS from Asian countries had greater access to NCD care than those from non-Asian countries.
Policymakers should consider expanding the insurance coverage to URAS, similar to coverage for Thai populations. Additional studies on refugees' health status and service utilization in other settings outside Bangkok are strongly recommended.
与其他非泰国人群相比，泰国城市难民和寻求庇护者（URAS）的健康状况研究较少，尤其是在慢性非传染性疾病（NCD）领域。本研究的目的是：i）检查非传染性疾病的患病率；ii）非传染性疾病服务的可及性；iii）与泰国人群相比，城市难民和寻求庇护者中与非传染性疾病服务可及性相关的因素。
2019年进行了一项横断面研究，使用了根据泰国健康与福利调查（HWS）改编的自填式问卷。URAS是从曼谷难民中心的登记册中随机选取的。181名URAS参与了调查。数据与来自HWS的2941份泰国记录相结合。人口范围限于曼谷。通过卡方检验、费舍尔精确检验和曼-惠特尼检验进行双变量分析，以检查URAS和泰国人在人口统计学和非传染性疾病服务可及性方面的差异。进行多变量逻辑回归以确定与非传染性疾病服务可及性相关的因素。
总体而言，URAS比泰国人更年轻、受教育程度更低且更贫困。非传染性疾病的趋势与泰国人群相似，只是心理健康障碍在URAS中似乎更为普遍。几乎一半的URAS没有接受任何正规治疗。参保、信奉佛教以及生活在更富裕的家庭是与更好地获得非传染性疾病服务相关的因素。来自亚洲国家的URAS比来自非亚洲国家的URAS获得非传染性疾病护理的机会更多。
政策制定者应考虑将保险覆盖范围扩大到URAS，类似于对泰国人群的覆盖范围。强烈建议在曼谷以外的其他地区对难民的健康状况和服务利用情况进行更多研究。
