Refugee children can have significant health problems. Our objective was to describe health status and health care utilization of refugee children after resettlement. A retrospective chart review of refugee children was performed. Initial laboratory data was extracted. Primary care visits, emergency room visits, and subspecialty referrals in the first 15 months from arrival were recorded. The sample included 198 refugees, many with positive initial screening tests. After arrival, 21% had an emergency department visit, 40% had a primary care sick visit, and 71% had a primary care follow-up. Mean number of visits ranged from 0.3 for emergency department to 1.9 for follow-up. Fifty-seven percent were referred to at least one subspecialist. Refugee children had substantial disease burden at arrival. Most had primary care follow-up visits and subspecialty referral after resettlement. These visits were largely for problems identified on initial screening and for general pediatric illnesses.
Language barriers and access to telephone advice have been shown to affect patient care. Less is known about access to telephone advice for families whose usual language is not English. The objective was to characterize the use of pediatric primary care telephone advice by families based on usual language spoken at home. A total of 277 surveys were completed by families presenting for sick visits at an academic pediatric primary care practice. No meaningful differences in the use of telephone advice when a child was sick were found by language category. Overall, 80.5% reported calling the clinic first when the clinic was open, but 77.6% went to the emergency department when the clinic closed. In conclusion, use of telephone advice was similar among families regardless of usual language. Most families reported going to the emergency department when the clinic was closed. More research is needed to identify barriers to the use of telephone advice, particularly after hours.
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