Journal of Immigrant and Minority Health

, Volume 21, Issue 4, pp 793–800 | Cite as

Emergency Department and Primary Care Use by Refugees Compared to Non-refugee Controls

  • Matthew A. Guess
  • Kawai O. Tanabe
  • Abigail E. Nelson
  • Steven Nguyen
  • Fern R. Hauck
  • Rebecca J. ScharfEmail author
Original Paper


The U.S. grants asylum to 60,000–70,000 refugees yearly. However, little is known about their healthcare utilization practices. We examined data from emergency department (ED) and primary care (PC) visits of 694 refugees and 738 non-refugee controls over a 3 years period at a large academic medical center, comparing visit frequencies, Emergency Severity Index (ESI) scores, diagnoses, and dispositions. Refugees used emergency care services less frequently than the non-refugee controls (1.19 vs. 2.31, p < 0.0001) while there was no difference in their use of primary care services (8.45 vs. 9.07, p = 0.18). Non-English-speaking refugees were more likely to use the ED than English-speaking refugees (mean ED use in study period 1.50 visits vs. 0.73, p < 0.0001). Refugee patients utilized emergency services less often compared to controls. These results differ from previously studied refugee populations. Refugee-specific primary care services in this study population may reduce unnecessary ED use.


Refugee Emergency department Healthcare utilization Primary care 

Supplementary material

10903_2018_795_MOESM1_ESM.docx (14 kb)
Supplementary Table 1 (DOCX 13 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Matthew A. Guess
    • 1
  • Kawai O. Tanabe
    • 2
  • Abigail E. Nelson
    • 3
  • Steven Nguyen
    • 4
  • Fern R. Hauck
    • 2
  • Rebecca J. Scharf
    • 5
    Email author
  1. 1.Department of Emergency MedicineHarbor-UCLA Medical CenterLos AngelesUSA
  2. 2.Department of Family MedicineUniversity of VirginiaCharlottesvilleUSA
  3. 3.Department of PediatricsPenn State UniversityHersheyUSA
  4. 4.Department of Family MedicineUniversity of New MexicoAlbuquerqueUSA
  5. 5.Developmental PediatricsUniversity of Virginia Children’s HospitalCharlottesvilleUSA

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