Refugees and asylum seekers are much more likely to die or become seriously ill than the general population because of barriers they face in accessing timely heath care, according to a new expert panel formed to address the issue.

Compared to the wider population, refugees face greater risk of suffering mental health conditions, infectious disease, nutritional deficiencies, obstetric complications, poor dental health and disability.

Refugees and asylum seekers are more likely to die or become seriously ill because of the barriers they face in accessing health care

Although people of refugee background are eligible for many of the same health services as other Australians, most face challenges when trying to access care with the panel identifying inefficiencies in the way the health needs of refugees are assessed and in how follow up care is delivered.

In response to this health crisis among refugees, a team of internationally renowned researchers and refugee health industry experts has been awarded a $1.1 million NHMRC Partnership grant to improve primary health care delivery to refugees living in Australia.

Led by Monash University and supported by AMES Australia and other settlement agencies, the project, called the OPTIMISE Partnership Project, will be supported by a further $1.1 million in cash and in-kind contributions from partner organisations.

According to lead researcher, Monash University’s Professor Grant Russell, refugees have complex health needs arising from past trauma and sub-optimal care prior to arrival.  While all states and territories accept refugees for resettlement, the majority settle in NSW and Victoria.

“Complex physical and psychological problems are often addressed only for the first time in Australia,” Professor Russell said.

“While specialist refugee services provide initial care for refugees on arrival, their long-term care is less assured with many refugees struggling to access mainstream general practitioners, specialists, community health services and hospitals due to language and cultural differences, limited understanding of the Australian health system and socioeconomic disadvantage,” he said.

He said that newly arrived refugees may turn to hospital emergency departments with serious conditions that could be better managed by community based services such as general practice.

Prof Russell said health providers were also under strain.

“Despite best efforts, general practitioners and other service providers can struggle to provide appropriate care to refugees because of limited knowledge of refugee health needs and difficulties with providing interpreters and culturally responsive care,” he said.

Prof Russell said that while the states have different systems to integrate refugees into the mainstream health system, it is becoming increasingly clear that refugees struggle to access appropriate, high quality primary care.

“Sometimes the first point of call for new, often preventable problems, is the hospital emergency department, which adds to the burden on Commonwealth health budgets,” he said.

The OPTIMISE Partnership Project will focus on three Australian regions with high refugee resettlement: South East Melbourne, North West Melbourne and South West Sydney.

In the last 10 years alone, these regions received 51,000 humanitarian entrants equivalent to 36 percent of national intake.

Over the next four years (2016-2020), the OPTIMISE Partnership Project will identify pressure points in the current system of care relating to the accessibility of, transition between and quality within health services for refugees. Researchers and industry experts will work in close collaboration to design interventions to address these system gaps in an effective and sustainable way.

The vision of the OPTIMISE Partnership Project is to build health system capacity for ensuring that people of refugee background receive the primary care they need when they need it, thus reducing inappropriate use of hospital emergency departments.

AMES Australia researcher Dr Lisa Thomson said quality research and evaluation was important in informing future service delivery and better client outcomes.

“As a provider of Settlement Services the findings of this study will have implications for how AMES clients transition to mainstream health services during the early years of settlement which are fundamental to their long term health and wellbeing,” Dr Thomson said.

Laurie Nowell
AMES Australia Senior Journalist