Factors affecting emergency department use among pediatric immigrants and refugees: A qualitative narrative review
Bibliographic record
Abstract
Purpose: To identify factors affecting emergency department (ED) use by immigrant and refugee children under the age of 18 years in North America and Europe, where similar primary, secondary, and tertiary healthcare structures exist. Methods: A narrative review methodology was used to complete a search of three databases including CINAHL, MEDLINE, and SCOPUS. Inclusion criteria and exclusion criteria were applied following screening and full-text review, resulting in the 8 articles that were selected for this review. Results: Six central themes were identified for presentation to ED’s including: (1) financial accessibility; (2) health insurance; (3) presence of a primary care provider; (4) language barriers; (5) transportation; and (6) health literacy, with health literacy further being divided into a lack of knowledge and parental perception and understanding of illness. Implications and Conclusion: Factors that influence ED use by pediatric immigrant and refugee patients are multi-factorial and interconnected. Recommendations are made to encourage informed changes based on population healthcare needs, with the overall goal to reduce non-essential ED use and improve patient health outcomes. While this review identifies and evaluates the limited research available in this area, further studies need to be completed before generalizations can be made for all pediatric immigrant and refugee populations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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 teacher head, 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".