The purpose of this paper is to identify factors, within a framework for integration, associated with healthcare utilization (primary care use, dental care, and insurance coverage) for Colorado refugees, by gender.
The Refugee Integration Survey and Evaluation project was a four-year longitudinal study of refugees that resettled in Colorado beginning in 2011. Refugees from Burma and Bhutan were used in this secondary data analysis. Various integration domains were explored as predictors, across gender groups, of the healthcare utilization outcome variables (physical exam in the past 12 months, dental exam in the past 12 months, and current healthcare coverage) using bivariate and multivariate logistic regression analyses.
In 2015, 73.1 percent of the sample reported accessing primary health care in the past year, and only 13.2 percent used dental care services. Nearly three-quarters reported having health insurance at the time of survey. In the adjusted models, there was a strong positive association between the outcome variable “physical exam” and the predictor variables “employment and economic self-sufficiency” (OR=0.70, p<0.001), “social bonding” (OR=3.73, p<0.001), and “safety and stability” (OR=2.23, p<0.001). Additionally, education and training predicted dental visit (OR=2.06, p<0.01). None of the integration domains were statistically significant predictors of dental visits in the adjusted models.
This study offers insights about facilitators and barriers to healthcare utilization uptake after resettling in a major US city. These findings can be used by agencies and governmental organizations to best tailor healthcare services and promotion of those services for this vulnerable population.
This study would not be possible without the support of Dr Gary Lichtenstein and Quality Evaluation Designs; the authors thank Gary for his advocacy on this project and thoughtful suggestions to strengthen this manuscript. The authors are grateful to The Colorado Department of Refugee Services for their support of the study and our analysis. Finally, the authors are very thankful to RISE participants for sharing their stories with the authors during data collection.
Alshadood, M., Harpin, S. and Puma, J. (2018), "Burmese and Bhutanese refugee utilization of healthcare services in Colorado", International Journal of Migration, Health and Social Care, Vol. 14 No. 4, pp. 400-410. https://doi.org/10.1108/IJMHSC-03-2018-0021Download as .RIS
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