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Geospatial Analysis of Refugee Access to Primary Care Physicians in San Antonio, Texas

  • Nicole J. Wong
  • Lung-Chang Chien
  • Hasanat Alamgir
Original Paper

Abstract

This study investigated refugee access to primary care physicians (PCP) in San Antonio, Texas. Catholic Charities of San Antonio (CCSA) is the primary agency responsible for connecting refugees to a PCP. Data on refugees were collected from CCSA between May to September 2013 (N = 547). PCPs information was accessed at the Texas Medicaid and Healthcare Partnership (TMHP) website. The 2SFCA method was used in geographic information systems (GIS) to analyze the ratio of healthcare providers relative to refugees within varying walking distances. The highest concentration of accessibility was at 20 min distance in the Medical Center area. The highest concentration of accessibility at all walking distances were also in the Medical Center area. The univariate and multivariate analyses did not result in significant findings for the association between demographic variables and the accessibility scores. These findings recommend building new and more relationships with healthcare providers where PCPs access is low.

Keywords

Refugee Health care access Primary care physician access San Antonio Texas 

Notes

Acknowledgements

The team sincerely thanks the Catholic Charities of San Antonio for their work and help in conducting this research.

Author Contributions

NW designed, collected and organized data, conducted GIS mapping analysis and writing. HA supervised and contributed to the writing. LC supervised the GIS analysis.

Funding

This study was not funded by any source.

Compliance with Ethical Standards

Conflict of interest

Authors have not received research grants from any source and have no conflict of interest. This study proposal has undergone review by the University of Texas Health Science Center Committee for Protection of Human Subjects and the Institutional Review Board (HCS-SPH-13-0824).

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors. This was a secondary data analyses and no individual identifier is there to identify the subjects.

Informed Consent

Informed consent was not necessary to obtain from all individual participants included in the study.

References

  1. 1.
    Texas Department of State Health Services (DSHS). Refugee Health Statistics 2013. http://www.dshs.state.tx.us/idcu/health/refugee_health/statistics.
  2. 2.
    Catholic Charities. Archdiocese of San Antonio, Inc. Refugee & Immigration Services. https://ccaosa.org/refugee-immigration-services.
  3. 3.
    Refugee Health Technical Assistance Center. Access to Care. 2011. http://refugeehealthta.org/access-to-care.
  4. 4.
    Allotey PA, Reidpath DD. Refugee intake: reflections on inequality. Aust N Z J Public Health. 2003;27(1):12–6.CrossRefGoogle Scholar
  5. 5.
    Steel Z, Chey T, Silove D, Marnane C, Bryant RA, van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302(5):537–49.CrossRefGoogle Scholar
  6. 6.
    Kaczorowski JA, Williams AS, Smith TF, Fallah N, Mendez JL, Nelson–Gray R. Adapting clinical services to accommodate needs of refugee populations. Prof Psychol: Res Pract. 2011;42(5):361.CrossRefGoogle Scholar
  7. 7.
    Barnes GW, Stoll HW, Barnes MS, Tiwari AD. The autoimmune response to male reproductive tissues of rabbits. IV. Induction of autosensitization to central accessory tissue by the intraabdominal release of endogenous secretions. Invest Urol. 1976;14(1):47–53.Google Scholar
  8. 8.
    Brouwer K. Assessment of community member attitudes towards health needs of refugees in San Diego. Retrieved July. (2007);8:2009.Google Scholar
  9. 9.
    Feldman R. Primary health care for refugees and asylum seekers: a review of the literature and a framework for services. Public Health. 2006;120(9):809–16.CrossRefGoogle Scholar
  10. 10.
    Cote S, Geltman P, Nunn M, Lituri K, Henshaw M, Garcia RI. Dental caries of refugee children compared with US children. Pediatrics. 2004;114(6):e733-40.CrossRefGoogle Scholar
  11. 11.
    Texas Medicaid and Healthcare Partnership. TMHP - Basic Provider Search 2013. http://opl.tmhp.com/ProviderManager/AdvSearch.aspx.
  12. 12.
    Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19(2):127–40.CrossRefGoogle Scholar
  13. 13.
    Fortney JC, Maciejewski ML, Warren JJ, Burgess JF. Jr. Does improving geographic access to VA primary care services impact patients’ patterns of utilization and costs? Inquiry. 2005;42(1):29–42.CrossRefGoogle Scholar
  14. 14.
    Guagliardo MF, Ronzio CR, Cheung I, Chacko E, Joseph JG. Physician accessibility: an urban case study of pediatric providers. Health Place. 2004;10(3):273–83.CrossRefGoogle Scholar
  15. 15.
    Kim M, Kotz D, Kim S, editors. Extracting a mobility model from real user traces. INFOCOM 2006 25th IEEE International Conference on Computer Communications Proceedings; 2006: IEEE.Google Scholar
  16. 16.
    Moussaïd M, Perozo N, Garnier S, Helbing D, Theraulaz G. The walking behaviour of pedestrian social groups and its impact on crowd dynamics. PLoS ONE. 2010;5(4):e10047.CrossRefGoogle Scholar
  17. 17.
    Hill T, Lewicki P. Statistics methods and applications. Tulsa: Statsoft; 2007.Google Scholar
  18. 18.
    Barnes DM, Harrison CL. Refugee women’s reproductive health in early resettlement. J Obstet Gynecol Neonatal Nurs. 2004;33(6):723–8.CrossRefGoogle Scholar
  19. 19.
    Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005;365(9467):1309–14.CrossRefGoogle Scholar
  20. 20.
    Stauffer WM, Kamat D, Walker PF. Screening of international immigrants, refugees, and adoptees. Prim Care. 2002;29(4):879–905.CrossRefGoogle Scholar
  21. 21.
    Yun K, Fuentes-Afflick E, Desai MM. Prevalence of chronic disease and insurance coverage among refugees in the United States. J Immigr Minor Health. 2012;14(6):933–40.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Nicole J. Wong
    • 1
  • Lung-Chang Chien
    • 2
  • Hasanat Alamgir
    • 3
  1. 1.University of Texas School of Public HealthSan Antonio CampusUSA
  2. 2.Epidemiology and Biostatistics program, Department of Environmental and Occupational HealthUniversity of Nevada, Las VegasLas VegasUSA
  3. 3.Department of Public HealthNew York Medical CollegeValhallaUSA

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