Health service access and utilization among Syrian refugees in Jordan
Health service access and utilization among Syrian refugees in Jordan
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DOI：
10.1186/s12939-016-0399-4
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发表时间：
2016-07-14
影响因子：
4.8
通讯作者：
Burnham, Gilbert
中科院分区：
文献类型：
--
作者：
Doocy, Shannon;Lyles, Emily;Burnham, Gilbert
背景：叙利亚难民涌入约旦给约旦卫生系统带来了巨大负担。生活方式的改变和人口老龄化正在将全球疾病负担转向非传染性疾病的增加，包括慢性病、合并症和伤害，这些疾病的管理更加复杂和昂贵。卫生系统承受的压力威胁到确保难民和东道国人口的卫生需求得到充分满足的能力。鉴于东道国政府和人道主义行动者面临的挑战越来越多，以满足叙利亚难民和受影响的东道国社区的健康需求，这项研究进行了评估叙利亚难民在非难民营settings.Methods的卫生服务的利用率：在约旦的叙利亚难民进行了调查，在2014年6月，以表征寻求健康的行为和相关的问题，以获得护理。一个集群设计与概率成比例的大小抽样，以达到全国代表性的样本1550非难民营叙利亚难民家庭。家庭特征的地理区域，设施类型和部门利用的差异进行了检查卡方和t检验methods.Results：寻求医疗保健是高的家庭报告的86.1%的成年人寻求医疗保健的最后一次，它是需要的。大约一半（51.5%）的服务是从公共部门设施寻求的，38.7%是从私人设施寻求的，9.8%是从慈善机构/非政府组织设施寻求的。在成年寻求护理者中，87.4%在最近一次就诊时开了药，其中89.8%获得了药物。总体而言，51.8%的家庭报告的自付费用的咨询或药物在最近的访问（平均值为39.9美元，中位数为4.2美元）。结论：尽管高层次的寻求医疗服务，成本是一个重要的障碍，在约旦的叙利亚难民获得卫生服务。自调查之时起，免费保健服务的停止可能使难民的保健公平状况恶化。难民依赖公共设施提供初级和专科护理，给约旦卫生系统造成了沉重负担。为了使难民和约旦收容社区都能公平地获得和负担得起保健服务，今后应考虑采取的战略包括将用于非传染性疾病和其他传统医院服务的资源转移到初级一级，并制定强有力的健康促进方案，强调预防和自我保健。
Background: The influx of Syrian refugees into Jordan presents an immense burden to the Jordanian health system. Changing lifestyles and aging populations are shifting the global disease burden towards increased noninfectious diseases including chronic conditions, co-morbidities, and injuries which are more complicated and costly to manage. The strain placed on health systems threatens the ability to ensure the health needs of both refugees and host country populations are adequately addressed. In light of the increasing challenges facing host governments and humanitarian actors to meet health needs of Syrian refugees and affected host communities, this study was undertaken to assess utilization of health services among Syrian refugees in non-camp settings.Methods: A survey of Syrian refugees in Jordan was undertaken in June 2014 to characterize health seeking behaviors and issues related to accessing care. A cluster design with probability proportional to size sampling was used to attain a nationally representative sample of 1550 non-camp Syrian refugee households. Differences in household characteristics by geographic region, facility type, and sector utilized were examined using chi-square and t-test methods.Results: Care-seeking was high with 86.1 % of households reporting an adult sought medical care the last time it was needed. Approximately half (51.5 %) of services were sought from public sector facilities, 38.7 % in private facilities, and 9.8 % in charity/NGO facilities. Among adult care seekers, 87.4 % were prescribed medication during the most recent visit, 89.8 % of which obtained the medication. Overall, 51.8 % of households reported out-of-pocket expenditures for the consultation or medications at the most recent visit (mean US$39.9, median US$4.2).Conclusions: Despite high levels of care-seeking, cost was an important barrier to health service access for Syrian refugees in Jordan. The cessation of free access to health care since the time of the survey is likely to have worsened health equity for refugees. Dependence of refugees on the public facilities for primary and specialist care has placed a great burden on the Jordanian health system. To improve accessibility and affordability of health services in an equitable manner for both refugees and Jordanian host communities, strategies that should be considered going forward include shifting resources for non-communicable diseases and other traditional hospital services to the primary level and creating strong health promotion programs emphasizing prevention and self-care are strategies.