Emergency Department and Primary Care Use by Refugees Compared to Non-refugee Controls

J Immigr Minor Health. 2019 Aug;21(4):793-800. doi: 10.1007/s10903-018-0795-5.


The U.S. grants asylum to 60,000-70,000 refugees yearly. However, little is known about their healthcare utilization practices. We examined data from emergency department (ED) and primary care (PC) visits of 694 refugees and 738 non-refugee controls over a 3 years period at a large academic medical center, comparing visit frequencies, Emergency Severity Index (ESI) scores, diagnoses, and dispositions. Refugees used emergency care services less frequently than the non-refugee controls (1.19 vs. 2.31, p < 0.0001) while there was no difference in their use of primary care services (8.45 vs. 9.07, p = 0.18). Non-English-speaking refugees were more likely to use the ED than English-speaking refugees (mean ED use in study period 1.50 visits vs. 0.73, p < 0.0001). Refugee patients utilized emergency services less often compared to controls. These results differ from previously studied refugee populations. Refugee-specific primary care services in this study population may reduce unnecessary ED use.

Keywords: Emergency department; Healthcare utilization; Primary care; Refugee.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*
  • Refugees / statistics & numerical data*
  • Retrospective Studies
  • United States