Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2020

Open Access 01-12-2020 | Care | Research

Preventable admissions and emergency-department-visits in pediatric asylum-seeking and non-asylum-seeking patients

Authors: Julia Brandenberger, Kayvan Bozorgmehr, Florian Vogt, Thorkild Tylleskär, Nicole Ritz

Published in: International Journal for Equity in Health | Issue 1/2020

Login to get access

Abstract

Background

Migrant health has become an essential part of public health. According to the World Health Organization, many health systems in Europe have not yet adapted adequately to the needs of asylum-seekers, which might result in untimely and inefficient health care for asylum-seeking patients. The aim of this study was to assess the number of preventable hospital admissions and emergency department visits in asylum-seeking and non-asylum-seeking pediatric patients.

Methods

This is a retrospective, hospital-based study. The study was done at the University Children’s Hospital Basel in Switzerland. Patients admitted or presenting to the emergency department were included and split into the groups of asylum-seeking and non-asylum-seeking patients.
All admissions and emergency-department visits were extracted from the administrative electronic health records from 1st Jan 2016-31st Dec 2017. The main outcome was the proportion of admissions due to ambulatory-care-sensitive conditions (which refer to conditions for which admission can be prevented by early interventions in primary care) in asylum-seeking and non-asylum-seeking patients. Ambulatory-care-sensitive conditions were defined by a validated list of ICD-10 codes.
The secondary objective was to assess the number of preventable emergency-department visits by asylum-seeking patients defined as proportion of visits with a non-urgent triage score.

Results

A total of 75′199 hospital visits were included, of which 63′405 were emergency department visits and 11′794 were admissions. Ambulatory-care-sensitive conditions accounted for 12.1% (18/149) of asylum-seeking and 10.9% (1270/11645) of non-asylum seeking patients’ admissions. Among the emergency department visits by asylum-seeking patients, non-urgent conditions accounted for 82.2% (244/297).

Conclusions

Admissions due to ambulatory-care-sensitive conditions are comparable in asylum-seeking and non-asylum-seeking children, suggesting few delayed presentations to ambulatory care facilities. Strategies to prevent non-urgent visits at pediatric emergency department facilities are needed.
Appendix
Available only for authorised users
Literature
1.
Abubakar I, Aldridge RW, Devakumar D, Orcutt M, Burns R, Barreto ML, Dhavan P, Fouad FM, Groce N, Guo Y, et al. The UCL-Lancet Commission on migration and health: the health of a world on the move. Lancet. 2018;392:2606–54.CrossRef
2.
The Lancet Public Health. No public health without migrant health. Lancet Public Health. 2018;3:e259.CrossRef
3.
Organisation; WH. Report on the health of refugees and migrants in the WHO European Region, vol. 1. Denmark: World Health Organization; 2018.
4.
Baauw A, Ritz N. Towards better healthcare for migrant and refugee children in Europe. Eur J Pediatr. 2018;177:161–2.CrossRef
5.
Kaur M, Singh S, Gupta M, Bahuguna P, Rani S. Inequity in access to health services between migrants and natives of Chandigarh, India. Int J Migr Health Soc Care. 2015;11:147–55.CrossRef
6.
Joshi C, Russell G, Cheng IH, Kay M, Pottie K, Alston M, Smith M, Chan B, Vasi S, Lo W, et al. A narrative synthesis of the impact of primary health care delivery models for refugees in resettlement countries on access, quality and coordination. Int J Equity Health. 2013;12:88.CrossRef
7.
8.
Pottie K, Batista R, Mayhew M, Mota L, Grant K. Improving delivery of primary care for vulnerable migrants Delphi consensus to prioritize innovative practice strategies. Can Fam Physician. 2014;60:E32–40.PubMedPubMedCentral
9.
Ritz N, Brinkmann F, Santiago Garcia B, Tebruegge M, Kampmann B. Paediatric tuberculosis network European trials g: tuberculosis in young refugees. Lancet. 2015;386:2475–6.CrossRef
10.
The Lancet. Migrant and refugee children need our actions now. Lancet. 2016;388:1130.PubMed
11.
Worabo HJ, Hsueh KH, Yakimo R, Worabo E, Burgess PA, Farberman SM. Understanding Refugees’ perceptions of health Care in the United States. J Nurse Pract. 2016;12:487–94.CrossRef
12.
Group IMW. ISSOP position statement on migrant child health. Child Care Health Dev. 2018;44:161–70.CrossRef
13.
Pohl C, Mack I, Schmitz T, Ritz N. The spectrum of care for pediatric refugees and asylum seekers at a tertiary health care facility in Switzerland in 2015. Eur J Pediatr. 2017;176:1681–7.CrossRef
14.
15.
Correa-Velez I, Ansari Z, Sundararajan V, Brown K, Gifford SM. A six-year descriptive analysis of hospitalisations for ambulatory care sensitive conditions among people born in refugee-source countries. Popul Health Metrics. 2007;5:9.CrossRef
16.
Bauhoff S, Gopffarth D. Asylum-seekers in Germany differ from regularly insured in their morbidity, utilizations and costs of care. PLoS One. 2018;13:e0197881.CrossRef
17.
Lichtl C, Lutz T, Szecsenyi J, Bozorgmehr K. Differences in the prevalence of hospitalizations and utilization of emergency outpatient services for ambulatory care sensitive conditions between asylum-seeking children and children of the general population: a cross-sectional medical records study (2015). BMC Health Serv Res. 2017;17:731.CrossRef
18.
19.
Farion KJ, Wright M, Zemek R, Neto G, Karwowska A, Tse S, Reid S, Jabbour M, Poirier S, Moreau KA, Barrowman N. Understanding low-acuity visits to the pediatric emergency department. PLoS One. 2015;10:e0128927.CrossRef
20.
Kim BS, Kim JY, Choi SH, Yoon YH. Understanding the characteristics of recurrent visits to the emergency department by paediatric patients: a retrospective observational study conducted at three tertiary hospitals in Korea. BMJ Open. 2018;8:e018208.CrossRef
21.
Sturm JJ, Hirsh D, Weselman B, Simon HK. Reconnecting patients with their primary care provider: an intervention for reducing nonurgent pediatric emergency department visits. Clin Pediatr (Phila). 2014;53:988–94.CrossRef
22.
23.
Anderson P, Craig E, Jackson G, Jackson C. Developing a tool to monitor potentially avoidable and ambulatory care sensitive hospitalisations in New Zealand children. N Z Med J. 2012;125:25–37.PubMed
24.
Becker DJ, Blackburn JL, Kilgore ML, Morrisey MA, Sen B, Caldwell C, Menachemi N. Continuity of insurance coverage and ambulatory care-sensitive hospitalizations/ED visits: evidence from the children's health insurance program. Clin Pediatr (Phila). 2011;50:963–73.CrossRef
25.
Casanova C, Colomer C, Starfield B. Pediatric hospitalization due to ambulatory care-sensitive conditions in Valencia (Spain). Int J Qual Health Care. 1996;8:51–9.PubMed
26.
Flores G, Abreu M, Tomany-Korman S, Meurer J. Keeping children with asthma out of hospitals: parents’ and physicians’ perspectives on how pediatric asthma hospitalizations can be prevented. Pediatrics. 2005;116:957–65.CrossRef
27.
Jaeger MW, Ambadwar PB, King AJ, Onukwube JI, Robbins JM. Emergency Care of Children with ambulatory care sensitive conditions in the United States. J Emerg Med. 2015;49:729–39.CrossRef
28.
Lu S, Kuo DZ. Hospital charges of potentially preventable pediatric hospitalizations. Acad Pediatr. 2012;12:436–44.CrossRef
29.
Prezotto KH, Chaves MM, Mathias TA. Hospital admissions due to ambulatory care sensitive conditions among children by age group and health region. Rev Esc Enferm USP. 2015;49:44–53.CrossRef
30.
Ebrahimi M, Heydari A, Mazlom R, Mirhaghi A. The reliability of the Australasian triage scale: a meta-analysis. World J Emerg Med. 2015;6:94–9.CrossRef
31.
Dinh MM, Berendsen Russell S, Bein KJ, Chalkley DR, Muscatello D, Paoloni R, Ivers R. Statewide retrospective study of low acuity emergency presentations in New South Wales, Australia: who, what, where and why? BMJ Open. 2016;6:e010964.CrossRef
32.
Nicolai T, Fuchs O, von Mutius E. Caring for the wave of refugees in Munich. N Engl J Med. 2015;373:1593–5.CrossRef
33.
Brandenberger J, Tylleskar T, Sontag K, Peterhans B, Ritz N. A systematic literature review of reported challenges in health care delivery to migrants and refugees in high-income countries - the 3C model. BMC Public Health. 2019;19(1):755.
34.
Alele FO, Callander EJ, Emeto TI, Mills J, Watt K. Socio-economic composition of low-acuity paediatric presentation at a regional hospital emergency department. J Paediatr Child Health. 2018;54:1341–7.CrossRef
35.
Vedovetto A, Soriani N, Merlo E, Gregori D. The burden of inappropriate emergency department pediatric visits: why Italy needs an urgent reform. Health Serv Res. 2014;49:1290–305.CrossRef
36.
Benahmed N, Laokri S, Zhang WH, Verhaeghe N, Trybou J, Cohen L, De Wever A, Alexander S. Determinants of nonurgent use of the emergency department for pediatric patients in 12 hospitals in Belgium. Eur J Pediatr. 2012;171:1829–37.CrossRef
37.
Kubicek K, Liu D, Beaudin C, Supan J, Weiss G, Lu Y, Kipke MD. A profile of nonurgent emergency department use in an urban pediatric hospital. Pediatr Emerg Care. 2012;28:977–84.CrossRef
38.
Hargreaves S, Friedland JS, Gothard P, Saxena S, Millington H, Eliahoo J, Le Feuvre P, Holmes A. Impact on and use of health services by international migrants: questionnaire survey of inner city London A&E attenders. BMC Health Serv Res. 2006;6:153.CrossRef
39.
McWilliams DB, Jacobson RM, Van Houten HK, Naessens JM, Ytterberg KL. A program of anticipatory guidance for the prevention of emergency department visits for ear pain. Arch Pediatr Adolesc Med. 2008;162:151–6.CrossRef
40.
McDermott KW, Stocks C, Freeman WJ. Overview of Pediatric Emergency Department Visits, 2015: Statistical Brief #242. In Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville: Agency for Healthcare Research and Quality (US); 2006.
41.
Robertshaw L, Dhesi S, Jones LL. Challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries: a systematic review and thematic synthesis of qualitative research. BMJ Open. 2017;7:e015981.CrossRef
Metadata
Title
Preventable admissions and emergency-department-visits in pediatric asylum-seeking and non-asylum-seeking patients
Authors
Julia Brandenberger
Kayvan Bozorgmehr
Florian Vogt
Thorkild Tylleskär
Nicole Ritz
Publication date
01-12-2020
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2020
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-020-01172-w

Other articles of this Issue 1/2020

International Journal for Equity in Health 1/2020 Go to the issue

Research

Intersecting inequalities, gender and adolescent health in Ethiopia

Research

Salutogenic model of health to identify turning points and coping styles for eating practices in type 2 diabetes mellitus

Research

Is the allocation of medical and health resources effective? Characteristic facts from regional heterogeneity in China

Research

Inequity in inpatient services utilization: a longitudinal comparative analysis of middle-aged and elderly patients with the chronic non-communicable diseases in China

Research

Two-eyed seeing of the integration of oral health in primary health care in Indigenous populations: a scoping review

Research

Vulnerability in health and social capital: a qualitative analysis by levels of marginalization in Mexico