Considering the current global political climate, it’s no surprise that refugees and asylum seekers face barriers to accessing health care. Language difficulties, financial need and unemployment, cultural differences, legal barriers and a health workforce with generally low awareness of issues specific to refugees are just some of the barriers faced by humanitarian entrants to any country.
Importantly, current Australian government migration and settlement policy also impacts on access to health and health status. An adequate understanding of these is a prerequisite for health providers and health service managers if they are to tailor health care and services appropriately.1
A Once-only Assessment is Available
Refugee Health Assessments are covered under the Medicare Benefits Schedule (MBS) and are a one-off comprehensive assessment that must be undertaken within 12 months of refugee or asylum seeker arrival.2
The health assessment must include the assessment of the patient’s:
- social functioning; and
- whether preventive health care and education should be offered to the patient to improve their health.
Psychological history should take into account possible long term effects of torture and other forms of trauma.
Clinical investigations will vary with country of origin, age, gender and any previous tests.
Consider the following based on clinical need:
- FBC, iron studies
- malaria Ag+/- film
- Schistosomiasis and Strongyloides serology
- Hepatitis B & C
- serum vitamin D
- faecal examination for parasites
- STI screen
- further TB (ie latent infection) and HIV assessment
- catch-up immunisation
- relevant preventative health checksThe medical practitioner should keep a record of the health assessment and offer to provide the patient with a written report about the health assessment. Patient consent to the health assessment should be documented in the patient’s record.
Refer to the Department of Health Fact Sheet on Refugee Health Assessments for more information
- Murray SB and Skull SA. Australian Health Review, 2005;29 (1):25-29
- Department of Health Australia: Medicare Benefits Schedule (MBS) health assessments for refugees and other humanitarian entrants