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减少健康差距:寻求庇护儿童进一步诊断转诊的依从性。

Reducing health disparities: Adherence to referrals for further diagnosis among asylum seeking children.

机构信息

Sackler Faculty of Medicine, Nursing Department, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.

出版信息

Public Health Nurs. 2022 Nov;39(6):1246-1254. doi: 10.1111/phn.13120. Epub 2022 Jul 21.

Abstract

OBJECTIVE

Asylum-seeking children are most vulnerable to health problems and non-utilization of health amenities. The aim of the study was to compare adherence with referrals for further diagnostic tests among asylum-seeking children and native Israeli children.

DESIGN

A retrospective cohort study.

SAMPLE

The study was conducted among 3508 children born in 2016-2017, with two randomized sample groups: Israeli children (n = 243) and asylum-seeking children (n = 271). Data were retrieved from the children's medical files.

MEASUREMENTS

Referrals for further diagnostic tests were defined as written referrals by a public health nurse or pediatrician. Data collected included the child's and mother's details, as well as data on referrals. A multiple logistic regression test was performed to detect risk variables for non-adherence to referrals.

RESULTS

No differences were found between the groups regarding adherence to referrals for further diagnosis. Having medical insurance did not explain adherence to referrals. Asylum-seeking children have more need for further follow-up than do Israeli children.

CONCLUSION

Asylum-seeking children and Israeli children respond similarly to the preventive health services offered with equal accessibility. Public health nurses have an essential role in encouraging adherence to screening tests and to referrals for further diagnostic tests and in mitigating health disparities among asylum-seeking children.

摘要

目的

寻求庇护的儿童最容易出现健康问题和无法使用医疗设施。本研究旨在比较寻求庇护的儿童和以色列本地儿童对进一步诊断性检查的转诊的依从情况。

设计

回顾性队列研究。

样本

该研究纳入了 2016-2017 年出生的 3508 名儿童,分为两组:以色列儿童(n=243)和寻求庇护的儿童(n=271)。数据来自儿童的医疗档案。

测量

进一步诊断性检查的转诊定义为公共卫生护士或儿科医生书面转诊。收集的数据包括儿童和母亲的详细信息,以及转诊信息。采用多因素逻辑回归检验来检测不依从转诊的风险变量。

结果

两组儿童在对进一步诊断的转诊的依从性方面没有差异。医疗保险并不能解释对转诊的依从性。寻求庇护的儿童比以色列儿童更需要进一步的随访。

结论

寻求庇护的儿童和以色列儿童对提供的预防保健服务有类似的反应,具有同等的可及性。公共卫生护士在鼓励进行筛查检查、转诊进一步诊断性检查以及减轻寻求庇护的儿童健康差异方面发挥着重要作用。

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