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Access of asylum seeker children to acute paediatric services
T Prendiville1, M Williamson, P Cahill
1Department of Paediatrics, University College Hospital Galway, Newcastle Road, Galway. terence.prendiville@gmail.com
Insights
Asylum seeker children less often see a general practitioner (GP) before attending the emergency department. They are more likely to use an ambulance, indicating potential over-reliance on hospital services.
Area of Science:
- Pediatrics
- Public Health
- Health Services Research
Background:
- Primary care access and referral patterns differ significantly between indigenous and asylum-seeking populations.
- Understanding these differences is crucial for optimizing healthcare delivery to vulnerable child populations.
Purpose of the Study:
- To investigate the referral interface between primary care and pediatric services for asylum-seeking children.
- To compare healthcare utilization patterns of asylum-seeking children with indigenous children.
Main Methods:
- A 3-month prospective study at UCHG (University College Hospital, Galway) involving questionnaire and clinical data collection.
- Inclusion of children of asylum-seeking families presenting to the A&E department.
- Comparison with a control group of consecutively seen Irish children.
Main Results:
- Asylum-seeking children were less likely to have seen a general practitioner (GP) prior to emergency department (A&E) presentation (8% vs. 32%).
- Asylum-seeking families were more likely to use emergency ambulance services (24% vs. 4%).
- Admission rates from A&E to the pediatric ward were lower for asylum-seeking children (24%) compared to controls (40%).
Conclusions:
- Asylum-seeking children demonstrate distinct healthcare-seeking behaviors, including reduced primary care engagement and increased reliance on emergency services.
- Findings suggest a potential over-dependence on pediatric hospital services among asylum-seeking children.
- Healthcare systems require tailored strategies to improve primary care integration for asylum-seeking children.
Abstract:
To investigate the interface between primary care and paediatric services in the referral of asylum seekers. Over a 3 month period a questionnaire was administered, and clinical data gathered on every child attending the A&E department of UCHG whose parents were seeking asylum in this country. Control data was obtained for the next Irish child seen on-call. At the time of presentation to the paediatric service, an Irish child was 4 times more likely (32%) to have initially been seen and referred by a GP than an asylum seeker child (8%); 80% of asylum seeker families had registered with a GP, compared to 96% of controls. 24% of asylum seeker families had called and used an emergency response ambulance to get to hospital, compared to just 4% of Irish children. The rate of subsequent admission to the paediatric ward from A&E was nearly that in asylum seeker children (24%) compared to Irish controls (40%), get to hospital, compared to just 4% of Irish children. Asylum seeker children are less likely to have seen a GP prior to A&E presentation, more likely to go to hospital by ambulance and less likely to be subsequently admitted, suggesting an over-dependence on paediatric hospital services in this population.
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