Integrated Primary Care Improves Access to Healthcare for Newly Arrived Refugees in Canada
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In this study we quantify the impact of a partnership between a dedicated health clinic for government assisted refugees (GARs), a local reception centre and community providers, on wait times and referrals. This study used a before and after, repeated survey study design to analyze archived administrative data. Using various statistical techniques, outcomes for refugees arriving 18 months prior to the introduction of the clinic were compared with those of refugees arriving in the 18 months after the clinic was established. Our investigation revealed wait times to see a health care provider decreased by 30 % with the introduction of a dedicated refugee health clinic. The likelihood of GARs being referred to physician specialists decreased by 45 %, but those referred were more likely to require multiple referrals due to increasingly complex medical needs. Referrals to non-physician specialist health care providers nearly doubled following the availability of the clinic. The time-limited, but intense health needs of GARs, require an integrated community-based primary healthcare intervention that includes dedicated health system navigators to support timely, more culturally appropriate care and successful integration.
KeywordsBefore and after study Refugee Primary care Canada
This research study was supported by the Social Sciences and Humanities Research Council of Canada through a Grant from the Centre of Excellence for Research on Immigration and Settlement (CERIS). Researcher Katherine Breward served on the Board of Directors of Reception House Waterloo during the time period under study. Neil Arya is the lead physician at the health clinic described and PI for the CERIS Grant. These relationships were fully disclosed during the ethics review process. The authors are not aware of any other competing interests. They would like to thank the staff and clients of Reception House and the Centre for Family Medicine in Kitchener.
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