Biomedical subjects

C Blöchliger

Publications and source records attributed to C Blöchliger.

4 recordsLinked to original sources

PubMed1998

[Asylum seekers and refugees in general practice: problems and possible developments].

Health and health services provided to asylum seekers and refugees by the Swiss National Health System have so far not been systematically investigated. The aim of this cross-sectional study was to describe the attending asylum seekers and refugees demographically and clinically, to identify main problem areas as perceived by general practitioners and to highlight options and venues for improvements. 272 questionnaires have been filled in by GPs of eight "federal districts" (Kantone) and the consultations of 1477 asylum seekers and refugees have been documented during one month in 193 surgeries. The documented asylum seekers and refugees reflected the distribution of this population in Switzerland. Low consultation rates of asylum seekers and refugees in the majority of surgeries and high diversity of this population in respect to places of origin, education and proficiency in languages appear to be the major determinants of the difficulties in providing adequate health services to them. Readily available information on the past medical history and on the ethnic background of these patients and continuing education on specific topics concerning health care for asylum seekers and refugees were thought to be particularly useful. This needs to be considered in the planning of services for this group. General practitioners specialized in health care for asylum seekers and refugees is an option for providing improved specific services (interpreters, institutional links, culturally adapted medical care).

Adolescent↗

PubMed1998

[Asylum seekers and refugees in the medical polyclinic: a comparison between the Basel, Bern and Geneva polyclinics].

This cross-sectional study describes the state of health of asylum seekers and refugees and the health services provided to them by the medical outpatient departments of three major Swiss university hospitals, Basel, Berne and Geneva. The comparison of outpatient departments differing in organisational structure facilitated the identification of positive and negative determinants of health service provision. Questionnaires have been filled in by all physicians of the three medical outpatient departments (Basel: 10, Berne: 1, Geneva: 36). All consultations of asylum seekers and refugees have been recorded during the study period (Basel: 42, Berne: 93, Geneva: 187). Interviews have been done with the physicians who coordinated the study. During the study period the majority of the patients originated from former Yugoslavia, Turkey, Sri Lanka, Somalia, Angola and Zaire. One of the most prominent features of the population investigated has been its diversity in respect to countries of origin, languages, ability to communicate and education. Diversity and low consultation rates per physician could explain many of the problems which have been observed, e.g. the lack of experience in specific approaches to these patients or difficulties to provide interpreters. To improve the health care for this group of patients in medical outpatient departments small teams of physicians should be selected. By these means adequate levels of experience could be achieved and organizational problems could be dealt with more effectively. In addition, the relationship between specific problems of asylum seekers and refugees and more general issues of the interaction between physicians and patients are discussed in view of tasks in research and training.

Adolescent↗

PubMed1998

[Asylum seekers and refugees in the emergency department].

This cross-sectional study describes the health problems and the health care of asylum seekers and refugees from the point of view of accident & emergency (A & E) physicians at the major hospital in St. Gallen, Switzerland. The physicians filled in a detailed questionnaire and documented all consultations of asylum seekers/refugees and of a control group of patients during eleven weeks (2 x 98 consultations). 76% of these asylum seekers/refugees originated from former Yugoslavia. The distribution of the main ICD-coded diagnoses did not differ between asylum seekers/refugees and the control group after correction for age. In comparison with the asylum seekers and refugees attending GPs, injuries were much more common in the A & E department attenders (37% vs. 8%). Asylum seekers/refugees and the patients in the control group did not differ in respect to being classified as an emergency case (58% vs. 65%). There were also no differences in hospitalisation rates (29% vs. 36%). Asylum seekers/refugees who were registered with a GP attended the A & E department more often during the night than during the day compared to patients who were not registered with a GP. Consultations which have been classified as emergencies occurred more frequently during the day than at night time. The time of residence in Switzerland was negatively associated with the registration with a GP and with being classified as an emergency case. A lack of experience in caring for asylum seekers and refugees and of specific training in this field has been the major complaint by the A & E physicians. Asylum seekers should be introduced to the tasks and functions of the various sectors of the national health care system as early as possible. Registration with a GP in the community should be promoted.

Adolescent↗

PubMed1997

[Asylum seekers and refugees in ambulatory health care: communication between physician and patient].

Communication between asylum seekers/refugees and general practitioners/physicians of the three main outpatient sectors for the Swiss national Health System (general practice, medical outpatient and accident & emergency departments) are being described and analysed. The data have been collected during three cross-sectional studies investigating the health status of asylum seekers and refugees and the health services provided to them. These studies addressed the problem exclusively from the point of view of the health care providers. Data on language capabilities, sociocultural aspects of communication and the necessity and availability of interpreters have been collected with questionnaires. The main results of the questionnaires have been followed up in group discussions with general practitioners. The majority of general practitioners/physicians felt that most of the communication problems were related to speaking a common language. Only about one out of two adult asylum seekers/refugees knew German, French, Italian or English. Particularly during the group discussions it was brought forward that cultural and social factors additionally complicate communication during patient-doctor interactions. When the data of the outpatient consultations of the main studies were analysed, it became obvious that interpreters were significantly more often present in consultations with patients with psychological/psychosocial diagnoses than those with somatic diagnoses (72% vs. 55%). This can be interpreted in two ways: (1) if a patient suffers from a psychological/psychosocial problem, it is more likely that an interpreter will be asked to assist during the consultation or (2) if an interpreter is present during a consultation, it is more likely that a psychological/psychosocial problem will be detected. With the exception of children, most of the general practitioners/physicians felt that non-professional interpreters (relatives, friends) were adequate for coping with most of the tasks. The following areas for improvements were identified: (1) availability of professional interpreters and quality as well as organisational issues related to interpretation, (2) language training for asylum seekers and refugees and (3) creation of awareness among general practitioners/physicians towards cultural and socioeconomic determinants of patient-doctor interactions and training.

Adult↗