Asylum Seekers and Swiss Nationals with Low-Acuity Complaints: Disparities in the Perceived level of Urgency, Health Literacy and Ability to Communicate-A Cross-Sectional Survey at a Tertiary Emergency Department.

Klingberg, Karsten; Stoller, Adrian; Müller, Martin; Jegerlehner, Sabrina; Brown, Adam D.; Exadaktylos, Aristomenis; Jachmann, Anne; Srivastava, David (2020). Asylum Seekers and Swiss Nationals with Low-Acuity Complaints: Disparities in the Perceived level of Urgency, Health Literacy and Ability to Communicate-A Cross-Sectional Survey at a Tertiary Emergency Department. International journal of environmental research and public health, 17(8) MDPI 10.3390/ijerph17082769

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Background: Emergency departments (EDs) are being increasingly used for low-acuity conditions and as primary care providers. Research indicates that patients with the status of asylum seeker (AS) may be seeking care in EDs at higher levels than nationals. The aim of this study was to identify disparities in the use of emergency care between AS and Swiss nationals (SN) with non-urgent complaints. Methods: Data were obtained from a survey in the period 01/12/2016-31/07/2017 of walk-in low-acuity patients attending the ED of the University Hospital Bern (Switzerland). AS and a gender, age-matched control group of SN of ≥16 years of age were included. Sociodemographic and survey data comprised information about health-seeking behavior in the home and reception country, knowledge of health care systems (HCSs), barriers to care and perceived acuity of the visit. Furthermore, attending physicians assessed the level of urgency of each case. Results: Among AS patients, 30.2% reported that they had no knowledge of the Swiss HCS. In total, 14.2% considered that their medical needs were non-urgent. On the other hand, 43.4% of the attending physicians in the ER considered that the medical needs were non-urgent. This contrast was less pronounced in SN patients. The majority of AS (63.2%) and SN (67.6%) patients sought care from the ED without first contacting a GP. In 53.8% of cases, an interpreter was needed during the ED consultation. Conclusions: Several factors associated with health-seeking behavior in the ED differed between AS and SN patients. Measures to increase health literacy, provision of easily accessible primary care services and intercultural-trained staff could improve quality of care and reduce the usage of EDs as primary care providers.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Klingberg, Karsten Werner; Müller, Martin; Jegerlehner, Sabrina; Exadaktylos, Aristomenis; Jachmann, Anne and Srivastava, David Shiva

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1660-4601

Publisher:

MDPI

Language:

English

Submitter:

Andrea Stettler

Date Deposited:

21 Dec 2020 14:25

Last Modified:

21 Dec 2020 14:32

Publisher DOI:

10.3390/ijerph17082769

PubMed ID:

32316445

Uncontrolled Keywords:

access to health care asylum seeker emergency department health-seeking behavior migrants non-urgent complaints refugee

BORIS DOI:

10.7892/boris.149998

URI:

https://boris.unibe.ch/id/eprint/149998

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