Evaluation of Emergency Department Visits by Refugee Children in Rhode Island.

Abstract

Children constitute 40% of the world's refugees and often have complex medical needs. This retrospective chart review examined Emergency Department (ED) utilization by pediatric refugees (aged 0-18) within a state-level healthcare system to understand the healthcare needs of this population. Pediatric refugee patients were defined as under the age of 18 years with the presence of the ICD-10 code "refugee health exam" in their electronic medical record (EMR). Between 2015-2023, 483 encounters were identified. Descriptive analysis was conducted on characteristics of these encounters. Arabic, Swahili, and Pushto were the most common primary languages of the 22 total languages identified. Most patients resided near the pediatric and adult tertiary care ED, but notably there was one ZIP code outside of the city that represented only 3.3% of all encounters but contributed to 10.6% of traumatic incidents. Medium-low acuity triage levels predominated (79.5%) with 87.8% of patients discharged. The highest percentage of medical (36%) and trauma (28%) visits were by Arabic speakers. Swahili and Spanish speakers had the highest percentage of mental health visits (50%, 36%). Although Arabic speakers had most patient encounters, they had no mental health visits. This study underscores the importance of exploring cultural, spatial, and social influences on ED visits, especially for trauma and mental health-seeking behavior in the pediatric refugee population.