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Detecting and describing heterogeneity in health care cost trajectories among asylum seekers

BACKGROUND: The mechanism underlying the health care cost trajectories among asylum seekers is not well understood. In the canton of Vaud in Switzerland, a nurse-led health care and medical Network for Migrant Health (“Réseau santé et migration” RESAMI) has established a health care model focusing o...

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Autores principales: Tzogiou, Christina, Spycher, Jacques, Bize, Raphaël, Sanchis Zozaya, Javier, Blaser, Jeremie, Pahud Vermeulen, Brigitte, Felappi, Andrea, Bodenmann, Patrick, Marti, Joachim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9339203/
https://www.ncbi.nlm.nih.gov/pubmed/35907845
http://dx.doi.org/10.1186/s12913-022-08346-y
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author Tzogiou, Christina
Spycher, Jacques
Bize, Raphaël
Sanchis Zozaya, Javier
Blaser, Jeremie
Pahud Vermeulen, Brigitte
Felappi, Andrea
Bodenmann, Patrick
Marti, Joachim
author_facet Tzogiou, Christina
Spycher, Jacques
Bize, Raphaël
Sanchis Zozaya, Javier
Blaser, Jeremie
Pahud Vermeulen, Brigitte
Felappi, Andrea
Bodenmann, Patrick
Marti, Joachim
author_sort Tzogiou, Christina
collection PubMed
description BACKGROUND: The mechanism underlying the health care cost trajectories among asylum seekers is not well understood. In the canton of Vaud in Switzerland, a nurse-led health care and medical Network for Migrant Health (“Réseau santé et migration” RESAMI) has established a health care model focusing on the first year after arrival of asylum seekers, called the “community health phase”. This model aims to provide tailored care and facilitate integration into the Swiss health care system. The aim of this study is to explore different health care cost trajectories among asylum seekers during this phase and identify the associated factors. METHODS: We detected different patterns of health care cost trajectories using time-series clustering of longitudinal data of asylum seekers in the canton of Vaud in Switzerland. These data included all adult asylum seekers and recipients of emergency aid who entered the canton between 2012 and 2015 and were followed until 2018. The different clusters of health care cost trajectories were then described using a multinomial logistic regression model. RESULTS: We identified a concave, an upward trending, and a downward trending cluster of health care cost trajectories with different characteristics being associated with each cluster. The likelihood of being in the concave cluster is positively associated with coming from the Eastern Mediterranean region or Africa rather than Europe and with a higher share of consultations with an interpreter. The likelihood of being in the upward trending cluster, which accrued the highest costs, is positively associated with 20–24-year-olds rather than older individuals, coming from Europe than any other region and having a mental disorder. In contrast to the other two clusters, the likelihood of being in the downward trending cluster is positively associated with having contacted the RESAMI network within the first month after arrival, which might indicate the potential of early intervention. It is also positively associated with older age and living in a group lodge. CONCLUSIONS: Asylum seekers are heterogeneous in terms of health care cost trajectories. Exploring these differences can help point to possible ways to improve the care and supporting services provided to asylum seekers. Our findings could indicate that early and patient-centered interventions might be well-suited to this aim. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08346-y.
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spelling pubmed-93392032022-08-01 Detecting and describing heterogeneity in health care cost trajectories among asylum seekers Tzogiou, Christina Spycher, Jacques Bize, Raphaël Sanchis Zozaya, Javier Blaser, Jeremie Pahud Vermeulen, Brigitte Felappi, Andrea Bodenmann, Patrick Marti, Joachim BMC Health Serv Res Research BACKGROUND: The mechanism underlying the health care cost trajectories among asylum seekers is not well understood. In the canton of Vaud in Switzerland, a nurse-led health care and medical Network for Migrant Health (“Réseau santé et migration” RESAMI) has established a health care model focusing on the first year after arrival of asylum seekers, called the “community health phase”. This model aims to provide tailored care and facilitate integration into the Swiss health care system. The aim of this study is to explore different health care cost trajectories among asylum seekers during this phase and identify the associated factors. METHODS: We detected different patterns of health care cost trajectories using time-series clustering of longitudinal data of asylum seekers in the canton of Vaud in Switzerland. These data included all adult asylum seekers and recipients of emergency aid who entered the canton between 2012 and 2015 and were followed until 2018. The different clusters of health care cost trajectories were then described using a multinomial logistic regression model. RESULTS: We identified a concave, an upward trending, and a downward trending cluster of health care cost trajectories with different characteristics being associated with each cluster. The likelihood of being in the concave cluster is positively associated with coming from the Eastern Mediterranean region or Africa rather than Europe and with a higher share of consultations with an interpreter. The likelihood of being in the upward trending cluster, which accrued the highest costs, is positively associated with 20–24-year-olds rather than older individuals, coming from Europe than any other region and having a mental disorder. In contrast to the other two clusters, the likelihood of being in the downward trending cluster is positively associated with having contacted the RESAMI network within the first month after arrival, which might indicate the potential of early intervention. It is also positively associated with older age and living in a group lodge. CONCLUSIONS: Asylum seekers are heterogeneous in terms of health care cost trajectories. Exploring these differences can help point to possible ways to improve the care and supporting services provided to asylum seekers. Our findings could indicate that early and patient-centered interventions might be well-suited to this aim. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08346-y. BioMed Central 2022-07-30 /pmc/articles/PMC9339203/ /pubmed/35907845 http://dx.doi.org/10.1186/s12913-022-08346-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Tzogiou, Christina
Spycher, Jacques
Bize, Raphaël
Sanchis Zozaya, Javier
Blaser, Jeremie
Pahud Vermeulen, Brigitte
Felappi, Andrea
Bodenmann, Patrick
Marti, Joachim
Detecting and describing heterogeneity in health care cost trajectories among asylum seekers
title Detecting and describing heterogeneity in health care cost trajectories among asylum seekers
title_full Detecting and describing heterogeneity in health care cost trajectories among asylum seekers
title_fullStr Detecting and describing heterogeneity in health care cost trajectories among asylum seekers
title_full_unstemmed Detecting and describing heterogeneity in health care cost trajectories among asylum seekers
title_short Detecting and describing heterogeneity in health care cost trajectories among asylum seekers
title_sort detecting and describing heterogeneity in health care cost trajectories among asylum seekers
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9339203/
https://www.ncbi.nlm.nih.gov/pubmed/35907845
http://dx.doi.org/10.1186/s12913-022-08346-y
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