Newton-Dame Remle, Jacobson Laura, Wallach Andrew B, Silverman Erica, Dreyer Benard, Long Theodore
Author Affiliations: Office of Ambulatory Care and Population Health, New York City Health + Hospitals, New York, New York (Newton-Dame, Jacobson and Silverman); Office of Ambulatory Care and Population Health, New York City Health + Hospitals, NYU Grossman School of Medicine, New York, New York (Drs Wallach and Long); and Department of Pediatrics, New York City Health + Hospitals/Bellevue, NYU Grossman School of Medicine, New York, New York (Dr Dreyer).
J Public Health Manag Pract. 2025;31(3):477-485. doi: 10.1097/PHH.0000000000002106. Epub 2024 Dec 26.
Over 200 000 people seeking asylum have arrived in New York City from 2022 to 2024.
As the safety net hospital system for our city, New York City (NYC) Health + Hospitals (H + H) has taken the lead in caring for newly arrived asylum seekers. We used electronic medical record data to gain early insights into utilization and needs among these patients.
We developed a hybrid definition to identify patients who are asylum seekers and examined their demographics, insurance, utilization, primary billing diagnoses, and immunizations from the Epic EMR. We included data on other patients as a point of comparison and analyzed data separately for adult and pediatric patients.
In 2023, 15 233 or 1.4% of H + H patients were asylum seekers. Asylum seekers had fewer visits than other patients in 2023, and utilization was particularly driven by pregnancy and childbirth. Children seeking asylum were engaged in primary care at high rates. Documented childhood vaccinations were higher among asylum-seeking children engaged in primary care compared to those who were not. The majority of adults and children were insured. Adult primary care engagement was low, as were visits for those seeking care for behavioral health issues.
For adult asylum seekers, pregnancy and childbirth are key needs for adults. Increasing vaccination rates among children is critical and promoting engagement in primary care is a promising way to do so. Coordinated efforts are required to meet the varied needs of migrant arrivals, and safety net hospitals can play a key role in addressing their health care needs.
2022年至2024年期间，超过20万人抵达纽约市寻求庇护。
作为本市的安全网医院系统，纽约市卫生与医院管理局率先为新抵达的寻求庇护者提供护理。我们利用电子病历数据，尽早了解这些患者的医疗服务利用情况和需求。
我们制定了一个混合定义来识别寻求庇护者患者，并从Epic电子病历系统中检查了他们的人口统计学特征、保险情况、医疗服务利用情况、主要计费诊断和免疫接种情况。我们纳入了其他患者的数据作为比较点，并分别对成人和儿童患者的数据进行了分析。
2023年，纽约市卫生与医院管理局的患者中有15233人（占1.4%）是寻求庇护者。2023年，寻求庇护者的就诊次数少于其他患者，医疗服务利用主要由怀孕和分娩推动。寻求庇护的儿童接受初级保健的比例很高。与未接受初级保健的寻求庇护儿童相比，接受初级保健的寻求庇护儿童的儿童期疫苗接种记录更高。大多数成人和儿童都有保险。成人接受初级保健的比例较低，寻求行为健康问题护理的患者就诊次数也较低。
对于成年寻求庇护者来说，怀孕和分娩是成年人的关键需求。提高儿童疫苗接种率至关重要，促进他们参与初级保健是实现这一目标的一个有前景的途径。需要协调各方努力，以满足移民到来者的各种需求，安全网医院在满足他们的医疗需求方面可以发挥关键作用。
