Scoping review: barriers to primary care access experienced by immigrants and refugees in English-speaking countries
Bibliographic record
Abstract
Purpose This study examined 46 articles in total, which yielded 5 recurring themes: perceived discrimination, language barriers, socioeconomic barriers, cultural barriers and educational/knowledge barriers. The two most dominant themes found were the inability to speak the country's primary language and belonging to a culture with different practices and values from the host country. The review provides vital insights into the numerous challenges that immigrants and refugees encounter as they navigate through the primary care systems of English-speaking (E-S) countries and potential solutions to overcome these barriers. Design/methodology/approach Access to adequate healthcare plays a central part in ensuring the physical and mental wellbeing of society. However, vulnerable groups such as immigrants and refugees, face numerous challenges when utilizing these healthcare services. To shed further light on the barriers impacting healthcare quality, the authors’ team performed a scoping thematic review of the available literature on immigrant and refugees' experiences in primary healthcare systems across E-S countries. Articles were systematically reviewed while focusing on healthcare perceptions by immigrants, potential barriers and suggestions to improve the quality of primary care. Findings This work looked at qualitative and quantitative information, attempting to combine both paradigms to give a rich and robust platform with which to devise a further study through focus groups. Qualitative inquiry accounted for 28/46, or 61%, of studies, and quantitative inquiry made up 9/46, or 20%, while 9/46 or 20% combined both qualitative and qualitative. Emerging themes are -perceived ethnic discrimination faced by immigrants accessing primary care, language barriers, socioeconomic barriers, cultural barriers and educational barriers. Research limitations/implications Most medical journals rely on quantitative data to relate “results” and cases. The authors set out to change ways in which medical reports can be done. Most of the authors were solely trained in quantitative research; consequently, they had to learn to isolate themes and to use a narrative approach in the article. Practical implications Research implications clearly indicated that using a qualitative (phenomenological) approach with quantitative data created a human and reachable discourse around patient comfort and the realities of immigrants and refugees to E-S countries. The use of this research opens medical practitioners (and patients) to a richer understanding within a usually difficult arena. Social implications By understanding the qualitative nature of medical research, practitioners, students and mentors are able to bridge medical quantitivity to the human, widening doors to social science and medical collaboratory research. Originality/value As stated above, this work is important as it understands the human/patient element and de-emphasizes the medical obsession with quantifying the lives of patients through hard data. This is a unique collaboration that relies on the qualitative to pinpoint and define the difficulties of newcomers to E-S countries.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.132 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.021 | 0.021 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.007 | 0.005 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".