Evaluation of Child Emergency Department Utilization: Differences Between Refugee and Resident Children.

Objectives: Evaluation of emergency department (ED) utilization by Syrian refugee children will provide important information about their health care needs and utilization as a prerequisite for improving preventive health services and outcomes. We aimed to compare ED utilization of refugee and resident children in a tertiary university hospital in Istanbul, Turkey.Methods: Electronic medical records of Syrian refugee children ≤18 years old presenting to the ED between January 2013 and July 2019 were retrospectively reviewed and compared with the resident children.Results: The study population consisted of 7299 refugee and 690127 resident children admitted to the ED. Emergent cases were more frequent in Syrian refugees (2.2% vs 1.0% p<0.001). One third of Syrian children were under 12 months of age (31.0% vs 17.4%, p<0.001). Syrian children were more commonly hospitalized (7.9% vs 3.1% p<0.001). Rate of intensive care unit hospitalization (13.4% vs 9.4%, p=0.001) and neonatal hospitalization was higher in Syrians compared to resident children (29.3% vs 12.0%, p<0.001). Respiratory and gastrointestinal diseases were the most frequent diagnoses which were similar in both groups. Conclusion: Refugee children as compared to native children are more likely to present to the ED with high acuity conditions, at a younger age resulting in higher rates of inpatient admissions. Strategies to increase access to preventive health care services for young refugee children should be explored to decrease ED and hospital services and improve health outcomes.