Journal of Immigrant and Minority Health
Volume 17, Issue 5, October 2015
http://link.springer.com/journal/10903/17/4/page/1

.
Original paper
Factors Associated with Healthcare Utilization Among Arab Immigrants and Iraqi Refugees
D. Elsouhag, B. Arnetz, H. Jamil, M. A. Lumley…
Abstract
Arab migrants—both immigrants and refugees—are exposed to pre- and post- migration stressors increasing their risk for health problems. Little is known, however, about rates of, or factors associated with, healthcare utilization among these two groups. A sample of 590 participants were interviewed approximately 1 year post-migration to the United States. Factors associated with healthcare utilization, including active and passive coping strategies, were examined using logistic regressions. Compared to national healthcare utilization data, immigrants had significantly lower, and refugees had significantly higher rates of healthcare utilization. Being a refugee, being married, and having health insurance were significantly associated with medical service utilization. Among refugees, less use of psychological services was associated with the use of medications and having problem-focused (active) strategies for dealing with stress. Healthcare utilization was significantly higher among refugees, who also reported a greater need for services than did immigrants.

.
Does Integrated Care Affect Healthcare Utilization in Multi-problem Refugees?
Carol C. White, Craig A. Solid, James S. Hodges, Deborah H. Boehm
Abstract
A history of trauma is common in refugee populations and appropriate treatment is frequently avoided. Using a convenience sample of 64 patients in a Somali primary care clinic, a culture and trauma specific intervention was developed to address retention into appropriate treatment. One goal of the intervention was to improve the rate of engagement in psychotherapy after a mental health referral and to test the effect of psychotherapy on health care utilization using a staged primary care clinical tool. Forty-eight percent of patients given a mental health referral engaged in psychotherapy. Patients engaging in psychotherapy had higher baseline utilization and over 12 months trended towards less emergency room use and more primary care. Our findings suggest that the intervention improved referral and retention in mental health therapy for East African refugee women.