ASYLUM SEEKERS AND REFUGEES IN THE ACCIDE NT AND EMERGENCY DEPARTMENT

This cross-sectional study describes the health problems and the healt h care of asylum seekers and refugees from the point of view of accide nt & emergency (A & E) physicians at the major hospital in Sf. Gallen, Switzerland. The physicians filled in a detailed questionnaire and do cumented all consultations of asylum seekers/refugees and of a control group of patients during eleven weeks (2 x 98 consultations). 76% of these asylum seekers/refugees originated from former Yugoslavia. The d istribution of the main ICD-coded diagnoses did not differ between asy lum seekers/refugees and the control group after correction for age. I n comparison with the asylum seekers and refugees attending GPs, injur ies were much more common in the A & E department attenders (37% vs. 8 %). Asylum seekers/refugees and the patients in the control group did not differ in respect to being classified as an emergency case (58% vs . 65%). There were also no differences in hospitalisation rates (29 % vs. 36 %). Asylum seekers/refugees who were registered with a GP atten ded the A & E department more often during the night than during the d ay compared to patients who were not registered with a GP Consultation s which have been classified as emergencies occurred more frequently d uring the day than at night time. The time of residence in Switzerland was negatively associated with the registration with a GP and with be ing classified as an emergency case. A lack of experience in caring fo r asylum seekers and refugees and of specific training in this field h as been the major complaint by the A gr E physicians. Asylum seekers s hould be introduced to the tasks and functions of the various sectors of the national health care system as early as possible. Registration with a GP in the community should be promoted.