Connecting Refugees to Medical Homes Through Multi-Sector Collaboration
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As increasing numbers of refugees have resettled globally, an interdisciplinary group of stakeholders in Forsyth, North Carolina, recognized obstacles preventing coordinated medical care, which inspired the development of our Refugee Health Collaborative. This study assessed the Collaborative’s impact on access to coordinated care within patient-centered medical homes (PCMH). A Collaborative-developed novel algorithm guided the process by which refugees establish care in PCMHs. All refugees who established medical care in the two primary health systems in our county (n = 285) were included. Logistic non-linear mixed models were used to estimate the differences between three time frames: pre-algorithm, algorithm implementation and refinement, and ongoing algorithm implementation. After algorithm implementation, there has been a significant decrease in the time required to establish care in PCMHs, increased provider acknowledgment of refugee status, and decreased emergency department (ED) visits. Multi-disciplinary, organized collaboration can facilitate enhanced access to care for refugee families at the population level.
KeywordsRefugee Immigrant Medical home Community partnership Cross-sector collaboration Access to care
We would like to acknowledge all active members of the Forsyth Refugee Health Collaborative. Specifically, we recognize our partners at World Relief Triad, the nursing team at the Forsyth County DPH, Jennifer Morillo from the NC Refugee Health Program, NC DHHS/Division of Public Health, local medical practices who provide medical homes for refugee families, and the volunteer “Good Neighbor Teams” who, among many roles, facilitate access to medical care for refugee families. We would also like to acknowledge the Program in Community Engagement of the Wake Forest Clinical and Translational Science Institute (WF CTSI), which is supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR001420.
Compliance with Ethical Standards
Conflict of interest
Julie M. Linton, M.D. reports that she was a Community Intern with the Program in Community Engagement of the WFCTSI, for which she received 10% salary support. The WFCTSI is supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR001420. Lemaat Michael, B.A., Alexandra K. Brady, M.D., Greg Russell, M.P.H., Scott D. Rhodes, Ph.D., M.P.H., Shahla Namak, M.D., Laura Cody, B.S.B., Andrea Vasquez, B.S.W., Andrea Caldwell, R.N., B.S.N., and Jennifer Foy M.P.A. have no conflicts of interest to report.
Research Involving Human and Animal Participants
This article does not contain any studies with human participants or animals performed by any of the authors.
- 2.Palakodeti S. Chronic Disease Prevalence of a Refugee Population in Dayton, OH. 2012. Located at: Community Health and Preventive Medicine Commons, Dayton, Ohio. https://corescholar.libraries.wright.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=1073&context=mph. Accessed 10 May 2017.
- 5.Centers for Disease Control and Prevention. Refugee health guidelines. 2012. http://www.cdc.gov/immigrantrefugeehealth/guidelines/refugee-guidelines.html. Accessed 22 Nov 2017.
- 6.American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Osteopathic Association. Joint Principles of the Patient-Centered Medical Home 2007. http://www.aafp.org/dam/AAFP/documents/practice_management/pcmh/initiatives/PCMHJoint.pdf. Accessed 22 Nov 2017.
- 8.Wendel G. Philadelphia refugee health collaborative. Soc Innovations J. 2013(13). http://www.socialinnovationsjournal.org/76-featured-social-innovations/811-philadelphia-refugee-health-collaborative. Accessed 10 May 2017.
- 9.Payton C, Patel N, Scott K. Jefferson’s Center for Refugee Health: a model of community collaboration. Popul Health Matters. 2015;28(2):102. http://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1930&context=hpn. Accessed 10 May 2017.
- 10.Shah S, Yun K. Interest in collaborative, practice-based research networks in pediatric refugee healthcare. J Immigr Minor Health. 2016;2016:1–5Google Scholar