ASYLUM SEEKERS AND REFUGEES IN THE OUTPAT IENT DEPARTMENT (OPD) - A COMPARISON BETWEEN THE OPDS OF SWISS MAIN HOSPITALS IN BASEL, BERNE ANDGENEVA

This cross-sectional study describes the state of health of asylum see kers and refugees and the health services provided to them by the medi cal outpatient departments of three major Swiss university hospitals, Basel, Berne and Geneva. The comparison of outpatient departments diff ering in organisational structure facilitated the identification of po sitive and negative determinants of health service provision. Question naires have been filled in by all physicians of the three medical outp atient departments (Basel: 10, Berne: I, Geneva: 36). All consultation s of asylum seekers and refugees have been recorded during the study p eriod (Basel. 42, Berne: 93, Geneva: 187). Interviews have been done w ith the physicians who coordinated the study During the study period t he majority of the patients originated from former Yugoslavia, Turkey, Sri Lanka, Somalia, Angola and Zaire. One of the most prominent featu res of the population investigated has been its diversity in respect t o countries of origin, languages, ability to communicate and education . Diversity and low consultation rates per physician could explain man y of the problems which have been observed, e.g. the lack of experienc e in specific approaches to these patients or difficulties to provide interpreters. To improve the health care for this group of patients in medical outpatient departments small learns of physicians should be s elected. By these means adequate levels of experience could be achieve d and organizational problems could be dealt with more effectively In addition, the relationship between specific problems of asylum seekers and refugees and more general issues of the interaction between physi cians and patients are discussed in view of tasks in research and trai ning.