Department of Public Health Sciences, Frank Batten School of Leadership and Public Policy, University of Virginia, Charlottesville, VA, USA.
Claude Moore Health Sciences Library, University of Virginia, Charlottesville, VA, USA.
J Immigr Minor Health. 2023 Dec;25(6):1426-1462. doi: 10.1007/s10903-023-01477-2. Epub 2023 Apr 2.
Refugees encounter numerous healthcare access barriers in host countries, leading to lower utilization rates and poorer health outcomes. In the US, social inequities and fragmented health systems may exacerbate these disparities. Understanding these factors is necessary to ensure equitable care of refugee populations. A systematic literature review of qualitative studies on US adult refugee healthcare access from January 2000 to June 2021 was performed in accordance with PRISMA. Studies were analyzed deductively and then inductively to incorporate previous findings in other resettlement countries and emergence of US-specific themes. 64 articles representing 16+ countries of origin emerged from the final analysis, yielding nine interrelated themes related to health literacy, cost of services, cultural beliefs, and social supports, among others. The main challenges to refugees' healthcare access emerge from the interactions of care fragmentation with adverse social determinants. Given diverse barriers, integrated care models are recommended in treating refugee populations.
难民在收容国遭遇众多医疗保健获取障碍,导致利用率较低和健康状况较差。在美国,社会不平等和碎片化的医疗体系可能会加剧这些差距。了解这些因素对于确保难民人群获得公平的护理至关重要。本研究采用 PRISMA 标准,对 2000 年 1 月至 2021 年 6 月期间美国成年难民医疗保健获取的定性研究进行了系统的文献回顾。研究采用演绎和归纳分析方法,将其他重新安置国家的先前发现和美国特有的主题纳入其中。最终分析共产生了 64 篇文章,代表了 16 个以上的原籍国,得出了九个相互关联的主题,涉及健康素养、服务成本、文化信仰和社会支持等。难民获得医疗保健的主要挑战源于医疗服务碎片化与不利社会决定因素的相互作用。鉴于存在多种障碍,建议采用综合护理模式来治疗难民群体。