Utilization of Emergency Care by an East African Refugee Community Compared to Local Residents in Central Minnesota: A Cross-Sectional Study

ABSTRACT Background Previous studies on emergency service utilization by refugees have been mixed, with some showing overuse and others showing underuse relative to host populations. Much of the previous literature focuses on refugees by continent of origin, which may mask important differences within immigrant groups. Limited research has investigated emergency medicine utilization for East African refugees in the United States. Methods The current study investigated differences in ED service utilization for East African refugees compared to local residents at an Emergency Trauma Center (Level 2) in Central Minnesota. From a convenience sample of 48 East African refugees and 116 local residents that presented to an emergency department (ED) in Central Minnesota, survey data was collected on self-reported reasons for presenting to ED; chart review data was collected on care received at the emergency department and discharge diagnoses. Results Logistic regressions showed that refugees were significantly (p < .05) more likely than local residents to self-report difficulties with navigating the primary care settings as a reason for presenting to the ED, and less likely to report needing specialized care. Refugees were also significantly less likely than local residents to call their primary care provider/clinic before presenting to the ED. During the ED visit, refugees were significantly more likely than local residents to receive symptomatic care and less likely to receive advanced imaging. Conclusion We hope these results spur additional research on this unique population, particularly related to health literacy and health equity in an emergency medicine setting for East African refugees continuing to migrate to the United States at high rates.