The impacts of adversity: Understanding the complex social and psychological reasons for asylum seekers and refugees attendance at primary health care services

Primary Care physicians in Australia are increasingly seeing asylum seekers and refugees with complex issues given the current political climate of uncertainty for this vulnerable patient group. Aim To describe the attendance... [ view full abstract ]

Primary Care physicians in Australia are increasingly seeing asylum seekers and refugees with complex issues given the current political climate of uncertainty for this vulnerable patient group.
Aim
To describe the attendance patterns of refugees and asylum-seekers to primary care, and understand the specific heath needs of this population as they settle into Australian society.
Methods
Descriptive study of health care consultations of all patients of a refugee primary health service (1 July 2011 - 31 June 2013), until they left the service, or until 28 February 2014. The types of health presentations including psychosocial issues were identified and described in comparison to Australian population presentations.
Results
471 patients (69.4% male), had 2527 consultations over 447.8 patient-years of observation. The main differences between attendance by refugee/asylum seeker patients and the overall Australian population to general practices are attendances for psychological reasons (27.2/100 encounters), endocrine and metabolic (12.11/100 encounters), and social reasons, including issues related to housing, family disruption, poverty (39.37/100 encounters).
Conclusions
Attendees to a refugee health service in the post-settlement period have markedly higher rates of attendance for catch-up primary health care, and social and psychological care. Asylum seekers as a specific group can have different health issues to those settling under permanent humanitarian visas. The forty-fold increase in attendance for social problems and three-fold increase in attendance for psychological reasons indicates the vulnerability of this population who often live in conditions of destitution. It is important to understand specific health needs so as to provide whole person care.