Emergency care utilization by refugee children compared to controls: A statewide database analysis.

Area of Science:

• Pediatric Healthcare
• Public Health
• Health Services Research

Background:

• Refugee children face significant barriers to sustained primary healthcare access following resettlement.
• Limited access to primary care may contribute to increased reliance on emergency department (ED) services.
• Understanding emergency care utilization patterns in refugee children is crucial for targeted interventions.

Purpose of the Study:

• To compare the proportion of ED claims between refugee children and general population controls.
• To assess differences in the median level of service (LOS) for ED visits between these groups.
• To analyze emergency care access patterns in pediatric refugee populations.

Main Methods:

• Retrospective cohort study using a statewide claims database (2014-2019).
• Identified refugee children via deterministic linkage; analyzed medical claims (ED vs. outpatient).
• Compared demographics, claim frequency (ED claims per 1000), and median LOS using chi-square tests.

Main Results:

• The proportion of ED claims was significantly higher in refugee children compared to general population controls (244 vs. 221 per 1000 claims, p=0.001).
• No significant difference was observed in the median level of service (LOS) for ED visits between the two groups.
• This indicates higher ED utilization across all acuity levels for refugee children.

Conclusions:

• Refugee children exhibit higher emergency department utilization rates than their general population peers.
• Similar levels of service (LOS) suggest that increased ED use is not solely for complex conditions.
• Further research is needed to explore healthcare disparities and develop targeted support services for refugee children.