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Enhanced Transitions of Care for Medically Complex Refugees
J Carey Jackson1, Nicole Chow Ahrenholz2, Heather Burkhalter3
1Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Washington, Box 359780, Seattle, WA, 98104, USA. jacksonc@uw.edu.
Background:
Between 2015 and 2019, 261,091 refugees were resettled through the U.S. Refugee Admissions Program. Few are chronically ill, but previously these went to emergency rooms upon arrival. We designed a pilot program to anticipate, assess, and safely assume care of chronic health needs and stabilize sick and medically complex refugees upon arrival.
Clinical Operations:
Academic internal medicine and pediatrics clinics are linked to the Washington State Refugee Health Program and Refugee Resettlement Agencies. Arriving refugees deemed medically complex through overseas medical evaluation or post-arrival were selected for the program.
Metrics:
We reviewed biodata of 2,947 refugees deemed medically complex. We referred five hundred and sixty one (19%) of these for evaluation, and 257 (46%) of referrals received care.
Discussion:
Safe transitions of care are standard practice in medical systems. This innovation in Seattle is one example of a system for the safe and cost-effective relocation of refugees with complex illnesses.
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