title: Integrated primary care improves access to healthcare for newly arrived refugees in Canada.
abstract: In this study we quantify the impact of a partnership between a dedicated health clinic for government assisted refugees (GARs), a local reception centre and community providers, on wait times and referrals. This study used a before and after, repeated survey study design to analyze archived administrative data. Using various statistical techniques, outcomes for refugees arriving 18 months prior to the introduction of the clinic were compared with those of refugees arriving in the 18 months after the clinic was established. Our investigation revealed wait times to see a health care provider decreased by 30 % with the introduction of a dedicated refugee health clinic. The likelihood of GARs being referred to physician specialists decreased by 45 %, but those referred were more likely to require multiple referrals due to increasingly complex medical needs. Referrals to non-physician specialist health care providers nearly doubled following the availability of the clinic. The time-limited, but intense health needs of GARs, require an integrated community-based primary healthcare intervention that includes dedicated health system navigators to support timely, more culturally appropriate care and successful integration.
authors.affiliation: School of Business and Economics/Health Studies, Wilfrid Laurier University, 73 George Street, Brantford, ON, N3T3Y3, Canada, jmcmurray@wlu.ca.
authors.forename: Josephine
authors.initials: J
authors.lastname: McMurray
authors.forename: Katherine
authors.initials: K
authors.lastname: Breward
authors.forename: Michael
authors.initials: M
authors.lastname: Breward
authors.forename: Rob
authors.initials: R
authors.lastname: Alder
authors.forename: Neil
authors.initials: N
authors.lastname: Arya
mesh_terms: D002170:Canada; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012036:Refugees; D014850:Waiting Lists