Assessing Refugee Utilization of Healthcare Systems

Background: The state of Utah does not systematically evaluate refugee healthcare programs and utilization. Two organizations in the Greater Salt Lake City Valley, Utah provide critical healthcare education and healthcare access to refugees. These two institutions do not have the means to assess the functionality of education delivery or the demographics of the population being served. The purpose of this project was to create a tool to appraise the efficacy of refugee education provided by a resettlement agency and to explore opportunities to strengthen software for refugee-specific health data collection at an academic medical center. Methods: To evaluate the efficacy of a refugee healthcare education program, a pre- and post-learning assessment tool was developed for the Health Mentor Program. Assessment results and recommendations were shared with key stakeholders. Healthcare employees were introduced to and appraised of the purpose and functionality of the electronic medical record Refugee FYI flag. The modified flag report captured additional refugee demographics and utilization for analysis. Descriptive statistics were used to summarize all collected data.Results: The learning module assessment revealed that participating refugees felt more confident after receiving mentor education. The Refugee FYI flag captured data about refugee demographics within the academic medical center and holds promise to be helpful. The typical refugee is a 33-year-old female who speaks either Arabic, Somalian, or Swahili. Refugee Urgent Care visits account for 12% of all refugee encounters whereas refugee Emergency department utilization is only 3% of refugee encounters. Of refugee emergency department visits, 18% result in a hospital admission. Conclusions: The pre- and post-learning assessment tool as designed was functional for the mentor/mentee pairs, but the questions should be revisited to enable statistical analysis. The availability of interpreters may limit the effectiveness of mentor teaching. The results of the Refugee FYI flag provided valuable baseline information about the 1,000+ refugees accessing care at an academic medical center in the Greater Salt Lake Valley. The needs and opportunities for refugee healthcare initiatives merit additional investment.