Migrants’ utilization of Emergency Departments for paediatric care in the North of England compared to that of non-migrants: a mixed methods study.

BACKGROUND: In the United Kingdom, children born to migrant parents are a rapidly growing group. Migrant populations, like all populations, require health services, but little is known about their use of emergency departments (EDs) for paediatric care. This study aimed to compare ED utilization between children born to migrant, as compared to non-migrant, parents in a region in the north of England. METHODS: This was a mixed methods study. Born in Bradford (BiB) cohort data were used to examine the association between paediatric ED utilization and maternal migration status. Fifteen semi-structured interviews with ED staff at two hospitals explored staff perceptions of migrant parents’ use of paediatric ED services. The final study used routine data to identify whether, and how, patterns of ED utilization differ between Roma and White British/ Irish children in Sheffield. FINDINGS: The main findings of this thesis are: 1) patterns of ED utilization for paediatric care differ between migrant and non-migrant populations; 2) people with different regions of origin utilize EDs differently and time since arrival in host country is an important consideration in understanding patterns of ED use; 3) broad categorizations of ‘migrant vs non-migrant’ do, however, have limited use in understanding patterns of ED use as these differ within migrant populations. CONCLUSION: While migrant status may be useful for health service planning, migrant status was not identified as a useful clinical variable, and this thesis found no evidence that migrant children were a population in greater need of emergency care. Instead, numerous individual, contextual, and process related factors are important in understanding patterns of ED utilization for people arriving in the UK. There is a need to explore, using an intersectional approach, the complex individual, family, community, and health system factors that may contribute to patterns of ED utilization by migrant populations.