'Fragmented care': Asylum seekers' experience of accessing health care in NSW.

Publisher: Oxford University Press Country of Publication: England NLM ID: 9008939 Publication Model: Print Cited Medium: Internet ISSN: 1460-2245 (Electronic) Linking ISSN: 09574824 NLM ISO Abbreviation: Health Promot Int Subsets: MEDLINE

Original Publication: Eynsham, Oxford, U.K. : Oxford University Press, c1990-

Refugees*/psychology; Aged ; Humans ; New South Wales ; National Health Programs ; Health Services Accessibility ; Australia

Medicare is central to accessing health care in Australia, yet many asylum seekers are ineligible for this scheme. In NSW, Medicare ineligible asylum seekers have some access to public health care under the Medicare Ineligible Asylum Seekers - Provision of Specified Public Health Services policy. This policy was updated in November 2020 to clarify services where a fee waiver applies for asylum seekers without Medicare. We examined the experiences of Medicare ineligible asylum seekers in accessing health care in New South Wales (NSW) in light of the revised policy. Employing qualitative methods, we conducted semi-structured interviews with asylum seekers (n = 7) and service providers (n = 6) in South Western Sydney. The interviews were analysed using thematic analysis and the socio-ecological model was used to interpret the data. Participants identified that chronic and mental health conditions are the main health issues for asylum seekers. Factors across the four levels of the socio-ecological model were identified as influencing the health care of asylum seekers, including a lack of awareness about health care rights at the individual level, support from relatives and friends at the interpersonal level, providers' lack of awareness of fee waivers at the organizational level and limited access to primary health care at the policy level. The results imply that Medicare ineligible asylum seekers in NSW do not have optimal access to health care which may worsen existing health disparities. Educational initiatives that improve service providers' and asylum seekers' awareness of the revised policy are needed to improve asylum seeker health equity in NSW.
(© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: [email protected].)

GRP0275471 NSW Refugee Health Service

Keywords: Asylum seekers; Australia; health care; health equity

Date Created: 20231021 Date Completed: 20231031 Latest Revision: 20231031

20240514

10.1093/heapro/daad123

37864803