Asylum seekers’ and refugees’ experiences of accessing health care: a qualitative study

Khanom, Ashrafunnesa; Alanazy, Wadad; Couzens, Lauren; Evans, Bridie; Fagan, Lucy; Fogarty, Rebecca; John, Ann; Khan, Talha; Kingston, Mark; Moyo, Samuel; Porter, Alison; Rhydderch, Melody; Richardson, Gillian; Rungua, Grace; Russell, Ian; Snooks, Helen

doi:10.3399/bjgpo.2021.0059

Cited by 14 publications

(16 citation statements)

References 29 publications

(36 reference statements)

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“… 3 , 4 , 5 , 6 , 7 For migrants who do register, there are barriers to accessing care, including insufficient translation support, discrimination, and transportation costs. 8 , 9 , 10 However, differences in primary care utilisation between migrants and the UK-born population are poorly understood and have relied on self-reported surveys with limited sample sizes and mixed results. 11 , 12 Examining these differences is of particular importance for service planning given the UK is home to the fifth largest number of international migrants in the world.…”

Section: Introductionmentioning

confidence: 99%

Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: An interrupted time series analysis

Zhang¹,

Boukari²,

Pathak³

et al. 2022

The Lancet Regional Health - Europe

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Section: Introductionmentioning

confidence: 99%

Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: An interrupted time series analysis

Zhang¹,

Boukari²,

Pathak³

et al. 2022

The Lancet Regional Health - Europe

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“…We will base our survey questions on those used successfully in the HEAR survey,9 focusing on knowledge of services, beliefs, experiences of injury, expectations and health-seeking behaviour. The questionnaire (see online supplemental file 2) will also include standardised questionnaires to measure satisfaction with care (Quality of Care Monitor)48 and current health status (SF-12) 49.…”

Section: Methodsmentioning

confidence: 99%

“… 7 However, there are concerns that people from ethnic minorities are more likely to make greater use of emergency healthcare, reflecting difficulties in accessing primary care. 8 In the Health Experiences of Asylum Seekers and Refugees (HEAR) study, 9 77% of survey respondents knew about the 999 service, but only 28% were aware of the Out of Hours GP service. Research across Europe 10 reports a rise in migrants’ and asylum seekers’ use of emergency services.…”

Section: Introductionmentioning

confidence: 99%

Building an understanding of Ethnic minority people’s Service Use Relating to Emergency care for injuries: the BE SURE study protocol

et al. 2023

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IntroductionInjuries are a major public health problem which can lead to disability or death. However, little is known about the incidence, presentation, management and outcomes of emergency care for patients with injuries among people from ethnic minorities in the UK. The aim of this study is to investigate what may differ for people from ethnic minorities compared with white British people when presenting with injury to ambulance and Emergency Departments (EDs).Methods and analysisThis mixed methods study covers eight services, four ambulance services (three in England and one in Scotland) and four hospital EDs, located within each ambulance service. The study has five Work Packages (WP): (WP1) scoping review comparing mortality by ethnicity of people presenting with injury to emergency services; (WP2) retrospective analysis of linked NHS routine data from patients who present to ambulances or EDs with injury over 5 years (2016–2021); (WP3) postal questionnaire survey of 2000 patients (1000 patients from ethnic minorities and 1000 white British patients) who present with injury to ambulances or EDs including self-reported outcomes (measured by Quality of Care Monitor and Health Related Quality of Life measured by SF-12); (WP4) qualitative interviews with patients from ethnic minorities (n=40) and focus groups—four with asylum seekers and refugees and four with care providers and (WP5) a synthesis of quantitative and qualitative findings.Ethics and disseminationThis study received a favourable opinion by the Wales Research Ethics Committee (305391). The Health Research Authority has approved the study and, on advice from the Confidentiality Advisory Group, has supported the use of confidential patient information without consent for anonymised data. Results will be shared with ambulance and ED services, government bodies and third-sector organisations through direct communications summarising scientific conference proceedings and publications.

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“…However, barriers to general practice (GP) registration and low registration rates are long-standing issues among international migrants (3)(4)(5)(6)(7). For migrants who do register, there are barriers to accessing care, including insufficient translation support, discrimination, and transportation costs (8)(9)(10). However, differences in primary care utilisation between migrants and the UKborn population are poorly understood and have relied on self-reported surveys with limited sample sizes and mixed results (11,12).…”

Section: Introductionmentioning

confidence: 99%

Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: An interrupted time series

Zhang

Boukari

Pathak

et al. 2022

Preprint

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Background: How international migrants access and use primary care in England is poorly understood. We aimed to compare primary care consultation rates between international migrants and non-migrants in England before and during the COVID-19 pandemic (2015-2020). Methods: Using linked data from the Clinical Practice Research Datalink (CPRD) GOLD and the Office for National Statistics, we identified migrants using country-of-birth, visa-status or other codes indicating international migration. We ran a controlled interrupted time series (ITS) using negative binomial regression to compare rates before and during the pandemic. Findings: In 262,644 individuals, pre-pandemic consultation rates per person-year were 4.35 (4.34-4.36) for migrants and 4.6 (4.59-4.6) for non-migrants (RR:0.94 [0.92-0.96]). Between 29 March and 26 December 2020, rates reduced to 3.54 (3.52-3.57) for migrants and 4.2 (4.17-4.23) for non-migrants (RR:0.84 [0.8-0.88]). Overall, this represents an 11% widening of the pre-pandemic difference in consultation rates between migrants and non-migrants during the first year of the pandemic (RR:0.89, 95%CI:0.84-0.94). This widening was greater for children, individuals whose first language was not English, and individuals of White British, White non-British and Black/African/Caribbean/Black British ethnicities. Interpretation: Migrants were less likely to use primary care before the pandemic and the first year of the pandemic exacerbated this difference. As GP practices retain remote and hybrid models of service delivery, they must improve services and ensure they are accessible and responsive to migrants' healthcare needs. Funding: This study was funded by the Medical Research Council (MR/V028375/1) and Wellcome Clinical Research Career Development Fellowship (206602).

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Asylum seekers’ and refugees’ experiences of accessing health care: a qualitative study

Cited by 14 publications

References 29 publications

Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: An interrupted time series analysis

Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: An interrupted time series analysis

Building an understanding of Ethnic minority people’s Service Use Relating to Emergency care for injuries: the BE SURE study protocol

Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: An interrupted time series

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