Insurance Status and Healthcare Utilization among Refugees with Chronic Disease in an Urban Safety Net Care System

Refugees with chronic noncommunicable diseases face health care challenges before, during and after resettlement to the United States.This retrospective chart study seeks to characterize refugees with chronic disease and their utilization of healthcare services in a metropolitan area.There were 295 patients included in this study.The mean age was 41 years, and 52% were male.The 5 most commonly spoken (non-English) languages were Burmese, Arabic, Nepali, Dari, and Somali with 22 other languages noted.English was spoken in 12.2% of participants.Hypertension was prevalent in 17.3% of refugees, 14.9% had dyslipidaemia, and 11.9% had diabetes mellitus.Approximately 70% of participants initially had governmentfunded insurance; after the refugee medical assistance period, only 58.3% still had government-funded insurance (p<0.001).Paired analysis did not show a statistically significant difference in the total cholesterol level, glucose level, or blood pressure of patients between clinic visits.Most patients attended scheduled follow-up clinic visits (71%).The present study revealed a significant decline in insurance status after 12 months and that the chronic disease burden was comparable to that of other refugee populations in the U.S. Optimizing healthcare for refugees with chronic noncommunicable diseases should focus on improving health insurance coverage.Future work in this population should assess patient health literacy and clinical adherence to treatment.