{"id":1724,"date":"2022-12-02T00:00:00","date_gmt":"2022-12-02T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/health-care-use-and-system-costs-among-pediatric-refugees-in-canada\/"},"modified":"2023-11-30T13:50:05","modified_gmt":"2023-11-30T18:50:05","slug":"health-care-use-and-system-costs-among-pediatric-refugees-in-canada","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/health-care-use-and-system-costs-among-pediatric-refugees-in-canada\/","title":{"rendered":"Healthcare use and system costs among pediatric refugees in Canada"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Resettled refugees land in Canada through 3 sponsorship models with similar health insurance and financial supports but differences in how resettlement is facilitated. We examined whether health system utilization, costs, and aggregate 1-year morbidity differed by resettlement model.<\/p>\n<p><strong>Methods<\/strong> \u2014 Population-based matched cohort study in Ontario, 2008 to 2018, including pediatric (0\u201317 years) resettled refugees and matched Ontario-born peers and categorized refugees by resettlement model: (1) private sponsorship (PSRs), (2) Blended Visa Office-Referred program (BVORs), and (3) government-assisted refugee (GAR). Primary outcomes were health system utilization and costs in year 1 in Canada. Multivariable logistic regression was used to test the associations between sponsorship model and major illnesses.<\/p>\n<p><strong>Results<\/strong> \u2014 We included 23 287 resettled refugees (13 360 GARs, 1544 BVORs, 8383 PSRs) and 93 148 matched Ontario-born. Primary care visits were highest among GARs and lowest in PSRs (median visits [interquartile range], GARs 4[2\u20136]; BVORs 3[2\u20135]; PSRs 3[2\u20135]; P &lt;.001). Emergency department visits and hospitalizations were more common among GARs and BVORs versus PSRs (emergency department: GARs 19.2%; BVORs 23.4%; PSRs 13.8%; hospitalizations: GARs 2.5%; BVORs 3.2%; PSRs 1.1%, P &lt;.001). Mean 1-year health system costs were highest among GARs (mean [standardized difference] $1278 [$7475]) and lowest among PSRs ($555 [$2799]; Ontario-born $851 [9226]). Compared with PSRs, GARs (adjusted odds ratio 1.63, 95% confidence interval 1.47\u20131.81) and BVORs (adjusted odds ratio 1.52, 95% confidence interval 1.26\u20131.84) were more likely to have major illnesses.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Healthcare use and morbidity of PSRs suggests they are healthier and less costly than GARs and BVOR model refugees. Despite a greater intensity of healthcare utilization than Ontario-born, overall excess demand on the health system for all resettled refugee children is low.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Resettled refugees land in Canada through 3 sponsorship models with similar health insurance and financial supports but differences in how resettlement is facilitated. We examined whether health system utilization, costs, and aggregate 1-year morbidity differed by resettlement model. Methods \u2014 Population-based matched cohort study in Ontario, 2008 to 2018, including pediatric (0\u201317 years) [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[16,19,27],"migration-helper-qa-sample-set":[],"class_list":["post-1724","journal_article","type-journal_article","status-publish","hentry","topic-children-and-young-people","topic-marginalized-populations","topic-pediatrics"],"acf":{"citation":"Saunders NR, Gandhi S, Wanigaratne S, Lu H, Stukel TA, Glazier R, Rayner J, Guttmann A. <em>Pediatrics<\/em>. 2023; 151(1):e2022057441. Epub 2022 Dec 2.","source_url":"https:\/\/publications.aap.org\/pediatrics\/article\/doi\/10.1542\/peds.2022-057441\/190230\/Health-Care-Use-and-System-Costs-Among-Pediatric","ices_scientist":[1238,1250,1348,1372,16891],"site":[6733],"research_program":[6747],"news_release":[7400],"journal_article":"","atlas":"","research_report":"","infographic":[9283],"video":"","downloads":null,"links":null,"sitecore_item_id":"9815C583-E41F-4908-9DB0-4E83CA2545B5","sitecore_item_name":"Health-care-use-and-system-costs-among-pediatric-refugees-in-Canada","sitecore_field_values":"{\r\n  \"Title\": \"Healthcare use and system costs among pediatric refugees in Canada \",\r\n  \"Short title\": \"Healthcare use and system costs\",\r\n  \"Summary\": \"This study examined whether health system utilization, costs, and aggregate 1-year morbidity differed by resettlement model.\",\r\n  \"Citation\": \"<p>Saunders NR, Gandhi S, Wanigaratne S, Lu H, Stukel TA, Glazier R, Rayner J, Guttmann A. <em>Pediatrics<\/em>. 2022; 151(1):e2022057441. Epub 2022 Dec 2. DOI: <a href=\"https:\/\/doi.org\/10.1542\/peds.2022-057441\" title=\"opens external link\">https:\/\/doi.org\/10.1542\/peds.2022-057441<\/a><\/p>\",\r\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Resettled refugees land in Canada through 3 sponsorship models with similar health insurance and financial supports but differences in how resettlement is facilitated. We examined whether health system utilization, costs, and aggregate 1-year morbidity differed by resettlement model.<\/p>n<p><strong>Methods<\/strong> &mdash; Population-based matched cohort study in Ontario, 2008 to 2018, including pediatric (0&ndash;17 years) resettled refugees and matched Ontario-born peers and categorized refugees by resettlement model: (1) private sponsorship (PSRs), (2) Blended Visa Office-Referred program (BVORs), and (3) government-assisted refugee (GAR). Primary outcomes were health system utilization and costs in year 1 in Canada. Multivariable logistic regression was used to test the associations between sponsorship model and major illnesses.<\/p>n<p><strong>Results<\/strong> &mdash; We included 23 287 resettled refugees (13 360 GARs, 1544 BVORs, 8383 PSRs) and 93 148 matched Ontario-born. Primary care visits were highest among GARs and lowest in PSRs (median visits [interquartile range], GARs 4[2&ndash;6]; BVORs 3[2&ndash;5]; PSRs 3[2&ndash;5]; P &lt;.001). Emergency department visits and hospitalizations were more common among GARs and BVORs versus PSRs (emergency department: GARs 19.2%; BVORs 23.4%; PSRs 13.8%; hospitalizations: GARs 2.5%; BVORs 3.2%; PSRs 1.1%, P &lt;.001). Mean 1-year health system costs were highest among GARs (mean [standardized difference] $1278 [$7475]) and lowest among PSRs ($555 [$2799]; Ontario-born $851 [9226]). Compared with PSRs, GARs (adjusted odds ratio 1.63, 95% confidence interval 1.47&ndash;1.81) and BVORs (adjusted odds ratio 1.52, 95% confidence interval 1.26&ndash;1.84) were more likely to have major illnesses.<\/p>n<p><strong>Conclusions<\/strong> &mdash; Healthcare use and morbidity of PSRs suggests they are healthier and less costly than GARs and BVOR model refugees. Despite a greater intensity of healthcare utilization than Ontario-born, overall excess demand on the health system for all resettled refugee children is low.<\/p>n<p><a href=\"https:\/\/publications.aap.org\/pediatrics\/article\/doi\/10.1542\/peds.2022-057441\/190230\/Health-Care-Use-and-System-Costs-Among-Pediatric\" title=\"opens external link\">View full text<\/a><\/p>\",\r\n  \"ICES Scientists\": \"{DF9D6D4F-1B33-4FB9-AD9B-576798163C2C}|{2C81C93C-B401-432B-8741-83841744D4CA}|{3BD36FC8-8BDA-44DB-8963-1B279EFDF236}|{A0978F87-1C10-4E62-A833-89616146CA59}\",\r\n  \"Posted Date\": \"20221202T000000\",\r\n  \"Show on Publications Landing Page\": \"1\",\r\n  \"In The News\": \"{BAC36A8B-BE5F-4795-B48F-7115BA244DB5}\"\r\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/December\/Health-care-use-and-system-costs-among-pediatric-refugees-in-Canada"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - 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