Grant: Operating Grant

Access to healthcare is a key factor in refugee health. On June 30, 2012, the federal government drastically reduced the scope of the Interim Federal Health Program (IFH), that previously covered medical services and medications for all refugee claimants and resettled refugees. Persons who are partially uninsured, as is now the case for refugee claimants, often delay medical consultation. Such delays may lead to worsening health conditions that require more costly interventions than providing timely primary care, and might also lead to increased critical incidents, morbidity and mortality. The main objective of this research project is to assess the impact of the June 2012 changes to the IFH program on refugee claimants' access to healthcare and the potential effects on their health, as well as on the cost of providing care to this population. A knowledge transfer strategy aimed at improving healthcare delivery to this population will subsequently be implemented. The study will be conducted in hospitals and primary care clinics of Toronto and Montreal where the majority of the approximately 100,000 refugee claimants live. It will have two components: First, a mixed-method quantitative and qualitative analysis will document the impact of IFH changes on costs, use of services and potential health consequences and identify the systemic factors impeding access to healthcare and their contribution to adverse outcomes. Second, healthcare providers' perceptions and practices regarding refugee claimants' access to healthcare will be assessed through an online survey and focus groups. The integrated knowledge translation strategy will help to inform knowledge, attitudes and practices of health professionals and administrative staff and to formulate policy recommendations that will be submitted to decision-makers in the federal and provincial governments as well as in healthcare institutions.