Retrospective evaluation of refugee and asylum-seeking patients presenting to the emergency department

ABSTRACT Retrospective Evaluation of Refugee and Asylum-Seeking Patients Presenting to the Emergency Department Objective: Refugees and asylum seekers constitute a major humanitarian issue affecting the entire world today. The aim of this study is to retrospectively evaluate the demographic characteristics, emergency department (ED) admissions, and the burden created by refugee and asylum-seeking patients presenting to the Emergency Department. Materials and Methods: A total of 5,203 patients who presented to the Emergency Department of our center over a 3-year period were included in the study. Demographic characteristics, comorbidities, most common reasons for ED visits, requested diagnostic tests, repeated admissions, and outcomes of patients in the ED were recorded. These data were analyzed using SPSS and MedCalc. Results: A total of 5,203 foreign-national patients who presented to the emergency department over a 3-year period were included in the study. The majority of the patients were young adults (84.3%), with a mean age of 32.0 ± 11.9 years. Most admissions were made to the green triage zone (57.4%), and 94.4% of the cases were classified as non-urgent/standard visits. The most common diagnoses were upper respiratory tract infections, soft tissue disorders, COVID-19, pregnancy-related conditions, and abdominal complaints. Regarding nationality, patients from Afghanistan and Syria constituted the majority. Within a 6-month period, 31.2% of patients revisited the ED and 34.8% revisited outpatient clinics. Repeated visits were most frequent in the green zone and least common in the pandemic zone (p < 0.001). Laboratory and imaging requests varied significantly by triage zone (p < 0.001). Hemogram, biochemistry, troponin, and INR tests were most frequently ordered in the yellow and red zones. X-ray and CT scans were notably more common in trauma and yellow-zone patients. Ultrasonography was used relatively more in the green zone but markedly less in the pandemic zone. MRI was most frequently requested in the yellow and red zones. There was a significant association between age groups and case types (p < 0.001): medicolegal cases and traffic accidents were more common in children/adolescents, while non-urgent visits predominated in adults. No significant association was found between nationality and case type (p = 0.631). Conclusion: In our study, 84% of the refugee and asylum-seeking patients presenting to the emergency department were between 18 and 44 years of age, most visits were made to the green triage zone, and 94.5% of admissions resulted in discharge. Our findings indicate that refugee and asylum-seeking patients tend to use the emergency department in place of primary healthcare services. Keywords: Refugee, Asylum seeker, Health, Emergency Department