Leps Caroline, Monteiro Jessica, Barozzino Tony, Bowry Ashna, Rashid Meb, Sgro Michael, Suleman Shazeen
Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, OntarioCanada.
McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada.
Paediatr Child Health. 2021 Aug 16;27(1):19-24. doi: 10.1093/pch/pxab045. eCollection 2022 Mar.
The Interim Federal Health Program (IFHP) provides health care coverage to refugees and refugee claimants, yet remains underused by providers. The objective of this study was to assess Canadian paediatricians' current understanding and utilization of the IFHP, and perceived barriers to utilization.
A one-time survey was administered via the Canadian Paediatric Surveillance Program in February 2020. In addition to descriptive statistics, multinomial logistic regressions were built to examine paediatrician use of the IFHP, and characteristics associated with registration and use.
Of the 2,753 physicians surveyed, there were 1,006 respondents (general paediatricians and subspecialists). 52.2% of respondents had provided care to IFHP-eligible patients in the previous 6 months. Of those participants, only 26.4% were registered IFHP providers, and just 16% could identify 80% or more of IFHP-covered services. Knowledge of 80% or more of IFHP-covered services was associated with registration status (adjusted odds ratio [aOR] 1.92; 95%CI 1.09 to 3.37). Among those who knew they were not registered, 70.2% indicated they did not know they had to register. aOR demonstrated that those with fewer years of practice had higher odds of not knowing that they had to register (aOR 1.22; 95%CI 1.01 to 1.49).
We demonstrate that IFHP is poorly utilized by paediatric providers, with low registration rates and poor understanding of IFHP-covered supplemental services, even among those who have recently provided care to IFHP-eligible patients. Efforts to improve registration and knowledge of IFHP are essential to improving access to health care for refugee children and youth.
临时联邦健康计划（IFHP）为难民和难民申请者提供医疗保健覆盖，但医疗服务提供者对其利用率仍然较低。本研究的目的是评估加拿大儿科医生目前对IFHP的理解和使用情况，以及使用过程中察觉到的障碍。
2020年2月通过加拿大儿科监测计划进行了一次性调查。除描述性统计外，还构建了多项逻辑回归模型，以研究儿科医生对IFHP的使用情况，以及与注册和使用相关的特征。
在接受调查的2753名医生中，有1006名受访者（普通儿科医生和专科医生）。52.2%的受访者在过去6个月中为符合IFHP资格的患者提供过护理。在这些参与者中，只有26.4%是注册的IFHP提供者，只有16%能够识别80%或更多的IFHP覆盖服务。知晓80%或更多IFHP覆盖服务与注册状态相关（调整后的优势比[aOR]为1.92；95%置信区间为1.09至3.37）。在那些知道自己未注册的人中，70.2%表示他们不知道自己必须注册。aOR表明，执业年限较少的人不知道自己必须注册的几率更高（aOR为1.22；95%置信区间为1.01至1.49）。
我们证明，儿科医疗服务提供者对IFHP的利用率很低，注册率低，对IFHP覆盖的补充服务了解不足，即使是那些最近为符合IFHP资格的患者提供过护理的人也是如此。努力提高对IFHP的注册率和了解程度对于改善难民儿童和青少年获得医疗保健的机会至关重要。
