Reasons for admission in asylum-seeking and non-asylum-seeking patients in a paediatric tertiary care centre
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Published on: June 12, 2020
Myriam Gmünder1, Julia Brandenberger2, Sina Buser3
1Faculty of Medicine, University of Basel, Switzerland, * Shared authorship.
Insights
Healthcare systems face challenges with arriving asylum-seeking children. This study found rare infections and mental health disorders were more common in these children, requiring specialized care and staff training.
Area of Science:
- Pediatric healthcare
- Public health
- Infectious diseases
Background:
- Europe has seen a rise in asylum-seeking children, straining local healthcare systems.
- Adapting healthcare services to meet the unique health needs of these children is crucial.
Purpose of the Study:
- To compare the spectrum of diseases and management strategies for hospitalized asylum-seeking children versus non-asylum-seeking children.
- To identify specific health challenges and care requirements for pediatric asylum seekers.
Main Methods:
- A retrospective cohort study analyzed health data of admitted children between January 2016 and December 2017.
- Electronic administrative and medical records were used for data collection.
Main Results:
- Asylum-seeking children (1% of admissions) showed higher rates of rare infectious diseases (15% vs 7%) and mental health disorders (6% vs 3%) compared to non-asylum-seeking children.
- Respiratory infections were common in both groups (17-19%), while injuries were more frequent in non-asylum-seeking children (22% vs 13%).
- Analgesic prescriptions were lower for asylum-seeking children, but antibiotic use was similar between groups.
Conclusions:
- Asylum-seeking children, though a small fraction of admissions, present distinct health concerns.
- While respiratory infections are common in both groups, rare infections and mental health issues necessitate targeted attention and staff training for pediatric asylum seekers.
Background:
In the last decade an increasing number of asylum-seeking children arrived in Europe and local healthcare systems have been challenged to adapt to their health needs. The aim of this study was to compare the spectrum of disease and management of asylum-seeking and non-asylum-seeking children requiring hospital admission.
Methods:
This was a retrospective cohort study including health data from recently arrived asylum-seeking and non-asylum-seeking children admitted between January 2016 and December 2017. Data were collected using electronic administrative and medical records.
Results:
Of 11,794 admissions of 9407 patients, 149 (1%) were asylum-seeking and 11,645 (99%) from non-asylum-seeking children. In asylum-seeking children the median age was 4 years (interquartile range [IQR] 0–13) with 61% males and in non-asylum-seeking children 4 years (IQR 0–11) years with 56% males. Respiratory infections accounted for 17–19% of admissions in both groups. Rare infectious diseases were more frequent in asylum-seeking children (15 vs 7%; difference in proportions 0.08, 95% confidence interval [CI] 0.02–0.14; p <0.001,). Injuries were more frequent in non-asylum-seeking children (22 vs 13%; difference in proportions 0.09, 95% CI 0.04–0.014; p <0.01). Admissions for mental health disorders were infrequent but more common in asylum-seeking children (6 vs 3%; difference in proportions 0.03, 95% CI −0.01 – 0.07; p = 0.02) Prescription of analgesics was lower in asylum-seeking than non-asylum-seeking children (3.4 vs 6.5 accounting units per admission). Antibiotic prescription was comparable in both groups.
Conclusion:
Asylum-seeking children represent a small number of total admissions. Age distribution and main reason for admission being diseases of the respiratory system were comparable in asylum-seeking and non-asylum-seeking children. Rare infections and mental health disorders are important diseases in asylum-seeking children and require special attention and training of staff working with paediatric asylum seekers.
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