Abstract
Objective: After the war in Syria, it is planned to investigate the refugee children’s (from diffrent counties coming to Turkey), emergency service admission features and evaluating outpatient and inpatient costs.
Material and Methods: Demographic, clinical characteristics and treatment costs of asylum seekers who applied to our pediatric emergency department from March 2011 to March 2016, the period of the civil war in Syria, were examined retrospectively.
Results: During the study period, 7551 (1.3%) of the 569.540 applications for emergency services were asylum seekers and the total number of patients was 1740. Of the 1740 patients who received one of the recurrent referrals; 975 were Syrian (56.0%), 474 were Iraqi (24.4%) and 341 were Afghan (19.6%). 1005 of the cases were male and the mean age was 59.16 ± 59.27 months (0- 17year 1 month). The most frequent admission reasons were respiratory system complaints (50.2%), gastrointestinal system complaints (34.7%) and fever (31.6%). 129 of the patients had an underlying disease (7.4%). At least one test was done in all cases. 60.7% of the patients were diagnosed with infection-related disease. These were URTI, AGE, tonsillitis, bronchiolitis, pneumonia and otitis respectively. In other cases, consultation was requested in 255 cases (14.7%). 182 (10.1%) of the patients were followed up with emergency observation. Mean
observation time was 21.3±17.4 hours (1-94 hours). The average outpatient clinic cost was 83.19 TL and the emergency hospital cost was 1288.89 TL for one patient.
Conclusion: It was seen that the most frequent cause of emergency admission in asylum seekers was infection related diseases. Bad living conditions and nutritional deficiencies can be the reason. This explains the recurrent emergency department visits. It has been determined that interpreters are required to deal with patients, that the examination time is longer than the other patients and that increase the costs associated with these patients
Keywords: Emergency service, Pediatric hospital, Refugee, War
References
- 1. Syria Regional Refugee Response. Inter-agency Information
- Sharing Portal. [LastCited on 2016 Jun 17]. Available from:http://
- www.data.unhcr.org/syrianrefugees/country.php?id=224.
- 2. 2016 Türkiye Göç raporu. Ankara: T.C. İçişleri Bakanlığı Göç İdaresi
- Genel Müdürlüğü Yayınları, 2017.
- 3. Oytun O, Gündoğar SS. Suriyeli Sığınmacıların Türkiye’ye Etkileri.
- ORSAM Raporu. 2015.
- 4. Korkmaz AÇ. Sığınmacıların Sağlık ve Hemşirelik Hizmetlerine
- Yarattığı Sorunlar. Sağlık ve Hemşirelik Yönetimi Dergisi 2014;1:
- 37-42.
- 5. Zencir M, Davas A. Suriyeli Sığınmacılar ve Sağlık Hizmetleri
- Raporu. Ankara: Türk Tabipler Birliği Yayınları, 2014.
- 6. Escobio F, Echevarria J, Rubaki S, Viniczai V. Health assistance of
- displaced people along the Balkan route. Lancet 2015;386:2475.
- 7. Tahirbegolli B, Çavdar S, Çetinkaya Sümer E, Akdeniz SI, Vehid S.
- Outpatient admissions and hospital costs of Syrian refugees in a
- Turkish university hospital. Saudi Med J 2016;37:809-12.
- 8. Doocy S, Lyles E, Akhu-Zaheya L, Burton A, Weiss W. Health
- service utilization and access to medicines among Syrian refugee
- children in Jordan. Int J Health Plann Manage 2016;31:97-112.
- 9. Beldjebel I. Infectious Diseases in Refugees Coming from Syria
- and Iraq to Lebanon. [LastCited on 2016 Jul 22]; 16th International
- Congress on Infectious Diseases (ICID) 2014 Vol.21:26. [Abstracts]
- Available from: http://www.dx.doi.org/10.1016/j.ijid. 2014.03.465.
- 10. Oğuz S, Tuygun N, Polat E, Akça H, Karacan CD. Savaş ve çocuk:
- Suriye iç savaşının sınırdan 750 km uzaktaki bir çocuk acil servisine
- etkisi. J Pediatr Emerg Intensive Care Med 2016;3:135-9.
- 11. Kendirci HNP, Çolakoğlu EY, Hızlı Ş, Koçak M, Saylam E, Polat
- E ve ark. Hastanemiz çocuk acil servisine başvuran zehirlenme
- olgularının değerlendirilmesi. Türkiye Çocuk Hast Derg 2011;5:29-
- 35.
- 12. Ertekin V, Altınkaynak S, Alp H, Yiğit H. Çocukluk çağında
- zehirlenmeler. Son üç yıldaki olguların değerlendirilmesi. Çocuk
- Derg 2001;1:104-9.
- 13. Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack
- BH, Heard SE. 2007 Annual Report of the American Association
- of Poison Control Centers’ National Poison Data System (NPDS):
- 25th annual report. Clin Toxicol (Phila) 2008;46:927-1057.
- 14. Wani KA, Ahmad M. Poisoning in children. JK - Practitioner
- 2004;11:274-5.
- 15. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO,
- Banner W. 2016 Annual Report of the American Association of
- Poison Control Centers’ National Poison Data System (NPDS):
- 34th annual report. ClinToxicol (Phila) 2017;55:1072-252.
- 16. Sümer V, Güler E, Karanfil R, Dalkıran T, Gürsoy H, Garipardıç M
- ve ark. Çocuk acil servisine başvuran zehirlenme olgularının geriye
- dönük olarak değerlendirilmesi. Turk Arch Ped 2011;46: 234-40.
- 17. Deniz T, Kandiş H, Saygun M, Büyükkoçak Ü, Ülger H, Karakuş
- A. Kırıkkale Üniversitesi Tıp Fakültesi Acil Servisine başvuran
- zehirlenme olgularının analizi. Düzce Tıp Fak Derg 2009;11:15-20.
- 18. Beniflah JD, Little WK, Simon HK, Sturm J. Effects of immigration
- enforcement legislation on Hispanic pediatric patient visits to the
- pediatric emergency department. Clin Pediatr (Phila) 2013;52:1122-
- 6.
- 19. Russo EG, Toselli S, Masotti S, Marzouk D, Sundquist K, Sundquist
- J. Health, growth and psychosocial adaptation of immigrant
- children. Eur J Public Health 2014;24:16–25.