Strategies to improve health care for patients with refugee status in King County, WA: Voices of Primary Care Providers

Abstract

The purpose of this research was to help identify priority areas, related to clinical care for refugees, in need of more support, assess the desire for more information on this topic among Primary Care Providers (PCPs), and to identify common challenges and potential strategies to providing quality health care for this population. A qualitative research study, using Participatory Action Research (PAR) methods, was conducted to address these issues. Semi-structured interviews and participant observation with PCPs were used for data collection. PCPs self-identified challenges, needs, and strategies involved in providing care for recently resettled refugees. The project resulted in the collection and analysis of qualitative data and found that the identification of recently arrived refugees was a major issue, communication, difficulty obtaining health history, increased encounter time for clinic visits, inadequate reimbursement rates were among the challenges. Several strategies for working with refugees include; adaptation of the clinic structure, the use of cultural navigators, improved sharing of health records, increased collaboration among public health and social service agencies, increased collaboration among PCPs working with similar populations and increased support for enhancement of cultural competence skills were also seen as potential solutions. This project was successful in fostering interdisciplinary collaboration between different individuals working with refugees in the health and social service sectors and raising awareness of gaps at the system-level. Recommendations include enhanced support for providers at the clinic, county, and state levels in order to improve the structures, policies, and methods for ensuring the delivery of culturally competent high quality care for all.