title: Immigrants and the utilization of hospital emergency departments.
abstract: BACKGROUND
  Immigrants with language barriers are at high risk of having poor access to health care services. However, several studies have indicated that immigrants tend to use emergency departments (EDs) as their primary source of care at the expense of primary care. This may place an additional burden on already overcrowded EDs and lead to a low level of patient satisfaction with ED care. The study was to review if immigrants utilize ED care differently from host populations and to assess immigrants' satisfaction with ED care.
  
  
  METHODS
  Studies about immigrants' utilization of EDs in Australia and worldwide were reviewed.
  
  
  RESULTS
  There are conflicting results in the literature about the pattern of ED care use among immigrants. Some studies have shown higher utilization by immigrants compared to host populations and others have shown lower utilization. Overall, immigrants use ED care heavily, make inappropriate visits to EDs, have a longer length of stay in EDs, and are less satisfied with ED care as compared to host populations.
  
  
  CONCLUSIONS
  Immigrants might use ED care differently from host populations due to language and cultural barriers. There is sparse Australian literature regarding immigrants' access to health care including ED care. To ensure equity, further research is needed to inform policy when planning health care provision to immigrants.
authors.affiliation: School of Public Health, Queensland University of Technology, Queensland, Australia.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Mahmoud
authors.affiliation: School of Public Health, Queensland University of Technology, Queensland, Australia.
authors.forename: Xiang-Yu
authors.initials: XY
authors.lastname: Hou
keywords: Emergency department; Health service; Immigrants; Language; Utilization