title: Factors Associated with Refugee Acute Healthcare Utilization in Southern Connecticut.
abstract: Our objective was to examine refugees' acute care use early in resettlement. We conducted a retrospective cohort study of acute care use, emergency room and hospital visits, by adult refugees arriving in Southern Connecticut between 2/1/2013 and 2/1/2015. We examined associations between any acute care use and collected demographic as well as health characteristics. Of the 248 refugees in our sample, 57% had a medical evaluation within 30 days of arrival. 102 (41%) had at least one acute care visit within 8 months of arrival. Male sex (OR 1.90, 95% CI 1.09-3.30) and prior history of hypertension (OR 2.87, 95% CI 1.06-7.33) were associated with greater likelihood of an acute care visit within 8 months of arrival, while having a medical evaluation within 30 days of arrival was associated with lower likelihood (OR 0.56, 95% CI 0.32-0.98). Designing systems to ensure timely evaluations of newly arrived refugees may reduce frequent acute care utilization.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA. wagahta.semere@yale.edu.|Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA. wagahta.semere@yale.edu.
authors.forename: Wagahta
authors.identifier: http://orcid.org/0000-0002-3795-2078
authors.initials: W
authors.lastname: Semere
authors.affiliation: Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Pooja
authors.initials: P
authors.lastname: Agrawal
authors.affiliation: Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Yun
authors.affiliation: Yale School of Medicine, New Haven, CT, USA.
authors.forename: Isha
authors.initials: I
authors.lastname: Di Bartolo
authors.affiliation: Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA.|Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Aniyizhai
authors.initials: A
authors.lastname: Annamalai
authors.affiliation: Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Ross
mesh_terms: D000328:Adult; D000367:Age Factors; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health / Q000208:ethnology*; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012036:Refugees / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors
keywords: Emergency department; Healthcare utilization; Hospital; Refugee