Asylum Seekers and Swiss Nationals with Low-Acuity Complaints: Disparities in the Perceived level of Urgency, Health Literacy and Ability to Communicate—A Cross-Sectional Survey at a Tertiary Emergency Department
Open Access
- 17 April 2020
- journal article
- research article
- Published by MDPI AG in International Journal of Environmental Research and Public Health
- Vol. 17 (8), 2769
- https://doi.org/10.3390/ijerph17082769
Abstract
Background: Emergency departments (EDs) are being increasingly used for low-acuity conditions and as primary care providers. Research indicates that patients with the status of asylum seeker (AS) may be seeking care in EDs at higher levels than nationals. The aim of this study was to identify disparities in the use of emergency care between AS and Swiss nationals (SN) with non-urgent complaints. Methods: Data were obtained from a survey in the period 01/12/2016–31/07/2017 of walk-in low-acuity patients attending the ED of the University Hospital Bern (Switzerland). AS and a gender, age-matched control group of SN of ≥16 years of age were included. Sociodemographic and survey data comprised information about health-seeking behavior in the home and reception country, knowledge of health care systems (HCSs), barriers to care and perceived acuity of the visit. Furthermore, attending physicians assessed the level of urgency of each case. Results: Among AS patients, 30.2% reported that they had no knowledge of the Swiss HCS. In total, 14.2% considered that their medical needs were non-urgent. On the other hand, 43.4% of the attending physicians in the ER considered that the medical needs were non-urgent. This contrast was less pronounced in SN patients. The majority of AS (63.2%) and SN (67.6%) patients sought care from the ED without first contacting a GP. In 53.8% of cases, an interpreter was needed during the ED consultation. Conclusions: Several factors associated with health-seeking behavior in the ED differed between AS and SN patients. Measures to increase health literacy, provision of easily accessible primary care services and intercultural-trained staff could improve quality of care and reduce the usage of EDs as primary care providers.Keywords
This publication has 28 references indexed in Scilit:
- Effects of immigrant status on Emergency Room (ER) utilisation by children under age one: a population-based study in the province of Reggio Emilia (Italy)BMC Health Services Research, 2013
- International Perspectives on Emergency Department CrowdingAcademic Emergency Medicine, 2011
- A Population-based Study of the Association Between Socioeconomic Status and Emergency Department Utilization in Ontario, CanadaAcademic Emergency Medicine, 2011
- Emergency medicine in China: present and futureWorld Journal of Emergency Medicine, 2011
- Systematic review of trends in emergency department attendances: an Australian perspectiveEmergency Medicine Journal, 2010
- Motivation and relevance of emergency room visits among immigrants and patients of Danish originEuropean Journal of Public Health, 2007
- Do Professional Interpreters Improve Clinical Care for Patients with Limited English Proficiency? A Systematic Review of the LiteratureHealth Services Research, 2006
- Emergency room utilization in Copenhagen: a comparison of immigrant groups and Danish-born residentsScandinavian Journal of Public Health, 2004
- Language barriers between nurses and asylum seekers: their impact on symptom reporting and referralSocial Science & Medicine (1982), 2003
- Nonurgent Emergency Department VisitsMedical Care, 1998