A cross sectional study of unmet need for health services amongst urban refugees and asylum seekers in Thailand in comparison with Thai population, 2019

International Journal for Equity in Health

Rapeepong Suphanchaimat¹  Panithee Thammawijaya²  Mathudara Phaiyarom³  Sataporn Julchoo³  Watinee Kunpeuk³  Pigunkaew Sinam³  Nareerut Pudpong³ 

[1] Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand;International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand;Division of Innovation and Research, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand;International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand;

关键词: Urban refugee;    Asylum seeker;    Unmet need;    Healthcare;    Thailand;   

DOI  :  10.1186/s12939-020-01316-y

来源: Springer

【 摘 要 】

BackgroundAlthough the Thai government has introduced policies to promote the health of migrants, it is still the case that urban refugees and asylum seekers (URAS) seem to be neglected. This study aimed to explore the degree of healthcare access through the perspective of unmet need in URAS, relative to the Thai population.MethodsA cross-sectional survey, using a self-reporting questionnaire adapted from the Thai Health and Welfare Survey (HWS), was performed in late 2019, with 181 URAS completing the survey. The respondents were were randomly selected from the roster of the Bangkok Refugee Center. The data of the URAS survey were combined with data of the Thai population (n = 2941) from the HWS. Unmet need for health services was defined as the status of needing healthcare in the past 12 months but failing to receive it. Bivariate analysis was conducted to explore the demographic and unmet need difference between URAS and Thais. Multivariable logistic regression and mixed-effects (ME) model were performed to determine factors associated with unmet need.ResultsOverall, URAS were young, less educated and living in more economically deprived households, compared with Thais. About 98% of URAS were uninsured by any of the existing health insurance schemes. The prevalence of unmet need among URAS was significantly higher than among Thais in both outpatient (OP) and inpatient (IP) services (54.1% versus 2.1 and 28.0% versus 2.1%, respectively). Being uninsured showed the strongest association with unmet need, especially for OP care. The association between insurance status and unmet need was more pronounced in the ME model, relative to multivariable logistic regression. URAS migrating from Arab nations suffered from unmet need to a greater extent, compared with those originating from non-Arab nations.ConclusionThe prevalence of unmet need in URAS was drastically high, relative to the prevalence in Thais. Factors correlated with unmet need included advanced age, lower educational achievement, and, most evidently, being uninsured. Policy makers should consider a policy option to enrol URAS in the nationwide public insurance scheme to create health security for Thai society.

【 授权许可】

CC BY