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Use of the emergency department by refugees under the Interim Federal Health Program: A health records review

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  • Francis Bakewell
  • Sarah Addleman
  • Garth Dickinson
  • Venkatesh Thiruganasambandamoorthy

Abstract

Introduction: In June 2012, the federal government made cuts to the Interim Federal Health (IFH) Program that reduced or eliminated health insurance for refugee claimants in Canada. The purpose of this study was to examine the effect of the cuts on emergency department (ED) use among patients claiming IFH benefits. Methods: We conducted a health records review at two tertiary care EDs in Ottawa. We reviewed all ED visits where an IFH claim was made at triage, for 18 months before and 18 months after the changes to the program on June 30, 2012 (2011–2013). Claims made before and after the cuts were compared in terms of basic demographics, chief presenting complaints, acuity, diagnosis, presence of primary care, and financial status of the claim. Bivariate or multivariate logistic regression analysis was performed to yield odds ratios (OR) with 95% confidence intervals. Results: There were a total of 612 IFH claims made in the ED from 2011–2013. The demographic characteristics, acuity of presentation and discharge diagnoses were similar during both the before and after periods. Overall, 28.6% fewer claims were made under the IFH program after the cuts. Of the claims made, significantly more were rejected after the cuts than before (13.7% after vs. 3.9% before, adjusted OR 4.28, 95% CI: 2.18–8.40; p

Suggested Citation

  • Francis Bakewell & Sarah Addleman & Garth Dickinson & Venkatesh Thiruganasambandamoorthy, 2018. "Use of the emergency department by refugees under the Interim Federal Health Program: A health records review," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-8, May.
    • Handle: RePEc:plo:pone00:0197282
    DOI: 10.1371/journal.pone.0197282
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    References listed on IDEAS

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    1. Andrea Evans & Alexander Caudarella & Savithiri Ratnapalan & Kevin Chan, 2014. "The Cost and Impact of the Interim Federal Health Program Cuts on Child Refugees in Canada," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-4, May.
    2. Kayvan Bozorgmehr & Oliver Razum, 2015. "Effect of Restricting Access to Health Care on Health Expenditures among Asylum-Seekers and Refugees: A Quasi-Experimental Study in Germany, 1994–2013," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-22, July.
    3. Dranove, David, 1988. "Pricing by non-profit institutions : The case of hospital cost-shifting," Journal of Health Economics, Elsevier, vol. 7(1), pages 47-57, March.
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