Download This Paper
Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.
Health and Illness in Newly Arrived Migrants and Refugees Arriving at Europe's Shores: Analysis of the Electronic Personal Health Record System in Seven Countries
30 Pages Posted: 21 Jun 2021
More...Abstract
Background: The electronic Personal Health (ePHR) Record is a health information system for newly arriving migrants that has been implemented in seven European countries (Bulgaria, Croatia, Cyprus, Greece, Italy, Serbia and Slovenia). This is a cross-sectional study of all migrants who attended as part of the health assessment programme established in the reception centres between 2016 and 2019 that provides a comprehensive overview of illness and health in the migrant cohort.
Methods: Data were collected on demographics, clinical and laboratory findings and diagnostics performed, including medical records. We classified all diseases using pre-specified algorithms according to information on prespecified variables from the ePHR questionnaire, ICD-10 codes, positive laboratory findings that identified a health condition or review of medical records using natural language processing. Crude and adjusted prevalence ratios or adjusted proportions were estimated using logistic regression modelling.
Results: The data set contained a total number of 19,564 clinical episodes in 14,440 individuals, recorded between 5 January 2016 to 4 October 2019. Most individuals (75%) were refugees or asylum seekers (22%) from 92 different nationalities. In total 811 (5.6%) individuals presented with cardiovascular disease and 1083 (8·2%) presented with a neurological condition. Having Diabetes Mellitus (OR 4, [95%CI 2·4-6·6], p<0.001), and neurological disorders (3·6, [95%CI 2·5-5·2], p<0.001) being older (OR 1·07 [95% CI 1·06-1·08]; p<0·001) and being male (OR 0·7, [95% CI 0·5-0·9]; p<0·001) was associated with cardiovascular disorders in the multivariable logistic regression model. Mental health problems were reported in 627 (4·4%) and were associated with older ages. There were 2,531 episodes of infectious diseases reported during the study period; 1283, (47·9%) pharyngo-tonsillitis, 529 (19·8%) scabies, 158 (6·2%) viral hepatitis and 156 (6·1%) lower respiratory infections.
Conclusions: We demonstrated that infectious diseases were common, particularly among children, with a significant minority having a range of chronic diseases. Our findings show an important and less known disease burden, making a strong case for the improvement of accuracy and quality of data to improve the efficiency of the health care delivery and the monitoring and surveillance of migrant health needs.
Funding: This work has been supported by a grant from the European Commission (N. 20175101).\
Conflict of Interest: All authors declare no competing interest.
Ethical Approval: Internal IOM approval was granted, no external approval was
needed, as this study is a service evaluation of routine systems and care. The reporting of this study conforms to the STROBE statement
Keywords: migrant; refugees; health data; electronic patient record; reception centres; health condition; chronic diseases; infectious diseases; mental health
Suggested Citation: Suggested Citation