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Asylum-Seeking Children with Medical Complexity and Rare Diseases in a Tertiary Hospital in Switzerland
S Buser1, J Brandenberger1,2, M Gmünder1
1Migrant Health Service, University of Basel Children's Hospital, Spitalstrasse 33, 4031, Basel, Switzerland.
Insights
This study highlights the unique healthcare needs of asylum-seeking children with medical complexity in Switzerland. New integrated care strategies are needed to address genetic diseases and nutritional problems in young asylum seekers.
Area of Science:
- Pediatrics
- Public Health
- Global Health
Background:
- Asylum-seeking children represent a vulnerable population with complex healthcare needs.
- Tertiary care hospitals manage a significant number of these children, requiring specific attention to their medical conditions.
Purpose of the Study:
- To characterize asylum-seeking children with medical complexity accessing tertiary care in Switzerland.
- To identify their common medical conditions and management patterns.
Main Methods:
- Retrospective analysis of administrative and electronic health records.
- Inclusion criteria focused on asylum-seeking patients with frequent visits between January 2016 and December 2017.
- Data collected on patient demographics, visit types, and diagnoses.
Main Results:
- 19 asylum-seeking children (4% of 462) met inclusion criteria, accounting for 811 visits.
- Common conditions varied by age: genetic and nutritional issues in those under 2 years; orthopedic and mental health problems in adolescents.
- Syrian origin was prevalent (47%).
Conclusions:
- Asylum-seeking children with medical complexity are a small but significant patient group.
- Current management may require enhanced strategies, particularly for young children with genetic diseases and nutritional deficits.
- Improved coordination and integrated care models are recommended.
Abstract:
The aim of this study was to assess the characteristics of asylum-seeking children with medical complexity visiting a tertiary care hospital in Switzerland, detailing their underlying medical conditions and management. Asylum-seeking patients with frequent visits between January 2016 and December 2017 were identified using administrative and electronic health records. Of 462 patients, 19 (4%) fulfilled the inclusion criteria with 811 (45%) visits. The age of the 19 patients ranged from 0 to 16.7 years (median of 7 years) with two main age groups identified: < 2 years and > 12 years. Nine (47%) patients originated from Syria. A total of 34/811(4%) visits were hospital admissions, 66/811 (8%) emergency department visits and 320/811(39%) outpatient department visits. In children < 2 years genetic diseases (5/8; 63%) and nutritional problems (6/8; 75%) were most common; in adolescents, orthopedic diseases (4/8; 50%) and mental health problems (4/8; 50%). Asylum-seeking children with medical complexity represent a small but important group of patients requiring frequent medical consultations. The high proportion of young patients with genetic diseases and severe nutritional problems suggests that new strategies are required in the management of this specific group of asylum-seeking children. This could be achieved by improved co-ordination between hospital and non-hospital care exploring options for integrated care.
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