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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

Author

Listed:
  • Karsten Klingberg

    (Emergency Department, University Hospital Bern, 3010 Bern, Switzerland)

  • Adrian Stoller

    (Emergency Department, University Hospital Bern, 3010 Bern, Switzerland)

  • Martin Müller

    (Emergency Department, University Hospital Bern, 3010 Bern, Switzerland)

  • Sabrina Jegerlehner

    (Emergency Department, University Hospital Bern, 3010 Bern, Switzerland
    Accident & Emergency, Barts Health NHS Trust, London EC1A 7BE, UK)

  • Adam D. Brown

    (Department of Psychology, New School of Social Research, New York, NY 10011, USA)

  • Aristomenis Exadaktylos

    (Emergency Department, University Hospital Bern, 3010 Bern, Switzerland)

  • Anne Jachmann

    (Emergency Department, University Hospital Bern, 3010 Bern, Switzerland
    These authors contributed equally to this work and are co-last authors.)

  • David Srivastava

    (Emergency Department, University Hospital Bern, 3010 Bern, Switzerland
    These authors contributed equally to this work and are co-last authors.)

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.

Suggested Citation

  • Karsten Klingberg & Adrian Stoller & Martin Müller & Sabrina Jegerlehner & Adam D. Brown & Aristomenis Exadaktylos & Anne Jachmann & David Srivastava, 2020. "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 Emergenc," IJERPH, MDPI, vol. 17(8), pages 1-11, April.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:8:p:2769-:d:346771
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    References listed on IDEAS

    as
    1. Jolanta Klukowska-Röetzler & Maria Eracleous & Martin Müller & David S. Srivastava & Gert Krummrey & Osnat Keidar & Aristomenis K. Exadaktylos, 2018. "Increased Urgent Care Center Visits by Southeast European Migrants: A Retrospective, Controlled Trial from Switzerland," IJERPH, MDPI, vol. 15(9), pages 1-13, August.
    2. Bischoff, Alexander & Bovier, Patrick A. & Isah, Rrustemi & Francoise, Gariazzo & Ariel, Eytan & Louis, Loutan, 2003. "Language barriers between nurses and asylum seekers: their impact on symptom reporting and referral," Social Science & Medicine, Elsevier, vol. 57(3), pages 503-512, August.
    3. Osnat Keidar & Sabrina N. Jegerlehner & Stephan Ziegenhorn & Adam D. Brown & Martin Müller & Aristomenis K. Exadaktylos & David S. Srivastava, 2018. "Emergency Department Discharge Outcome and Psychiatric Consultation in North African Patients," IJERPH, MDPI, vol. 15(9), pages 1-11, September.
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    Cited by:

    1. Ruth León-Pinilla & Ana Soto-Rubio & Vicente Prado-Gascó, 2020. "Support and Emotional Well-Being of Asylum Seekers and Refugees in Spain," IJERPH, MDPI, vol. 17(22), pages 1-17, November.
    2. Henrietta Bánfai-Csonka & Bálint Bánfai & Sára Jeges & József Betlehem, 2022. "Understanding Health Literacy among University Health Science Students of Different Nationalities," IJERPH, MDPI, vol. 19(18), pages 1-13, September.
    3. Anna Christina Nowak & Yudit Namer & Claudia Hornberg, 2022. "Health Care for Refugees in Europe: A Scoping Review," IJERPH, MDPI, vol. 19(3), pages 1-10, January.

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