Emergency health care for migrants: challenges in its provision
Citation: Harrison HL, Daker-White G. Beliefs and challenges held by medical staff about providing emergency care to migrants: an international systematic review and translation of findings to the UK context. BMJ Open. 2019;9(7):e028748.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: National Institute for Health Research (UK) Greater Manchester Patient Safety Translational Research Centre.
What is this? Emergency departments might be the first place and only contact for some migrants needing health care. Therefore, information on the challenges identified by emergency healthcare providers (ECPs) when providing care for migrants might help policy makers and practitioners delivering these services.
In this systematic review, the authors searched for qualitative studies on challenges identified by ECPs in providing health care for migrants in high-income settings. They restricted their searches to studies published in English and did the most recent search in March 2019. They included 11 studies, 4 of which studies were European Union funded EUGATE studies while the other studies were from Denmark (1), Germany (1), Spain (1), Sweden (3) and USA.
What was found? Language barriers, behaviors of migrants in the host country, gender dynamics and respect for authority were challenges experienced by ECPs when providing health care for migrants.
ECPs made cultural and organisational adjustments for migrant patients, but their willingness to do so was based on an individual’s clinical autonomy.
ECPs reported a lack of guidance or support relating to the management of undocumented migrants.
Implications: The authors of this review placed some of the conclusions in the UK context and stated that proposals to charge fees in emergency departments in the UK may widen healthcare disparities and they recommended consultation and assessment to understand the impacts of a charging policy on undocumented migrants and wider communities. They also recommended training and organisational support for the delivery of healthcare services in emergency departments.
Other considerations: The authors of the review discussed their findings in the context of culture, language, gender/sex, socioeconomic and legal status and marginalisation (migrants).
This summary was prepared by Tuba Yavuz, edited by Sydney Johnson and finalized by Mike Clarke.
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