title: The cost and impact of the interim federal health program cuts on child refugees in Canada.
abstract: BACKGROUND
  On June 30, 2012, Interim Federal Health Program (IFHP) funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown.
  
  
  METHODS
  We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross.
  
  
  RESULTS
  There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (p<0.001).
  
  
  CONCLUSIONS
  After the cuts to the IFHP, The Hospital for Sick Children was unable to obtain federal health coverage for the vast majority of refugee claimant children registered under the IFHP. This preliminary analysis showed that post-IFHP cuts healthcare costs at the largest tertiary pediatric institution in the country increased.
authors.affiliation: Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Evans
authors.affiliation: Department of Family Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Alexander
authors.initials: A
authors.lastname: Caudarella
authors.affiliation: Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Savithiri
authors.initials: S
authors.lastname: Ratnapalan
authors.affiliation: Department of Paediatrics, Eastern Health, Memorial University, St. John's, Newfoundland, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Chan
mesh_terms: D002170:Canada; D002648:Child; D003695:Delivery of Health Care / Q000191:economics* / Q000331:legislation & jurisprudence*; D004636:Emergency Service, Hospital / Q000191:economics; D005260:Female; D006291:Health Policy / Q000191:economics / Q000331:legislation & jurisprudence; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000191:economics; D012036:Refugees / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*