[Asylum seekers and refugees in the emergency department]

This cross-sectional study describes the health problems and the health care of asylum seekers and refugees from the point of view of accident & emergency (A & E) physicians at the major hospital in St. Gallen, Switzerland. The physicians filled in a detailed questionnaire and documented all consultations of asylum seekers/refugees and of a control group of patients during eleven weeks (2 x 98 consultations). 76% of these asylum seekers/refugees originated from former Yugoslavia. The distribution of the main ICD-coded diagnoses did not differ between asylum seekers/refugees and the control group after correction for age. In comparison with the asylum seekers and refugees attending GPs, injuries were much more common in the A & E department attenders (37% vs. 8%). Asylum seekers/refugees and the patients in the control group did not differ in respect to being classified as an emergency case (58% vs. 65%). There were also no differences in hospitalisation rates (29% vs. 36%). Asylum seekers/refugees who were registered with a GP attended the A & E department more often during the night than during the day compared to patients who were not registered with a GP. Consultations which have been classified as emergencies occurred more frequently during the day than at night time. The time of residence in Switzerland was negatively associated with the registration with a GP and with being classified as an emergency case. A lack of experience in caring for asylum seekers and refugees and of specific training in this field has been the major complaint by the A & E physicians. Asylum seekers should be introduced to the tasks and functions of the various sectors of the national health care system as early as possible. Registration with a GP in the community should be promoted.