Ortopedi Gözüyle Göçmen Çocuk Sağlığı: Yerel Çocuklardan Farkı Var mı?

Yıl 2023, Cilt: 20 Sayı: 1, 155 - 162, 27.04.2023

Özlem Orhan , Ahmet Yiğit Kaptan , Baki Volkan Çetin , Mehmet Akif Altay

https://doi.org/10.35440/hutfd.1258265

Öz

Amaç: Kamu sektörü sağlık kuruluşlarına başvuran göçmen çocukların sayısı artmaktadır. Bununla birlikte, özellikle ortopedi disiplininde nispeten az sayıda çalışma sağlık sistemleri üzerindeki etkilerini araştırmıştır. Bu araştırma, göçmenler ve yerel çocuklar arasında ortopedi ve travmatoloji polikliniklerine (O&T) kabulde anlamlı bir fark olup olmadığını araştırmaktadır.
Materyal ve metod: Retrospektif bu çalışmaya, 2019-2021 yılları arasında üçüncü basamak bir hastanenin O&T'sine başvuran 18 yaşın altındaki göçmen ve yerel hastalar dahil edildi. Hastaların demografik verileri, bir yıl içindeki başvuru sayısı, başvuru yeri, başvuru nedeni, tedavi yöntemi, radyolojik görüntüleme ve tanıları (yumuşak doku travması (YDT), gelişimsel kalça displazisi (GKD) vb.) her iki grup için değerlendirildi.
Bulgular: Çalışmaya 481 göçmen ve 528 yerel çocuk olmak üzere 1009 hasta dahil edildi. Başvuru sayısı göçmen çocuklarda 1-2 yaş arasında daha yüksekti (p=0,02). Göçmen çocukların acil servis ve diğer bölümlerden konsültasyonları yerel çocuklardan istatistiksel olarak daha yüksekti (p<0,001). Kırık/komplikasyonlar ve YDT yerel ve göçmen gruplarda en sık görülen tanılardır. Üçüncü en sık tanı yerel çocuklarda GKD ve göçmen çocuklarda genel muayene idi. MRG ve radyolojik görüntüleme istenmeyen incelemeler göçmen çocuklarda daha sıktı.
Sonuç: O&T'ye kabul ve diğer hizmetlerden konsültasyon sayısının göçmen çocuklarda daha yüksek olması dikkat çekicidir. Hekimlerin kültürel farklılıklar ve beklentiler konusundaki farkındalığını artırmak ve göçmen ailelere tercih ettikleri dilde profesyonel tercümanlar aracılığıyla sağlık eğitimi vermek sağlık üzerindeki bu yükü azaltabilir.

Anahtar Kelimeler

Çocuk, sağlık, göçmen, ortopedi ve travmatoloji, mülteci

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Immigrant Child Health Through the Eyes of Orthopedics: Is There a Difference Between Local Children

Öz

Background: The number of immigrant children admitted to public sector healthcare facilities is increasing. However, comparatively few studies investigated its effects on health systems, especially in the orthopedics discipline. This research investigates if there is a significant difference in admission to orthopedics and traumatology outpatient clinics (O&T) between immigrants and local children.
Materials and Methods: Immigrant (IP) and local patients (LP) under 18 admitted to the O&T of a tertiary hospital between 2019-2021 were included in this retrospective study. Demographic data of patients, number of admission in a year, place of admission, the reason for admission, treatment method, radiological imaging, and diagnoses (soft tissue trauma (STT), developmental hip dysplasia (DDH), etc.) were evaluated for both groups.
Results: 1009 patients were included (n=481 LP, n=528 IP). The number of admissions was higher in IP between 1 and 2 years (p=0.02). The consultations of IP from the emergency department and other departments were statistically higher than those of LP (p<0.001). Fracture/complications and STT are the most common diagnoses in local and immigrant groups. The third most common diagnosis was DDH in LP and general examination in IP. Examinations with MRI and no radiological imaging were more frequent in IP than in LP. Conclusions: It is noteworthy that the number of admissions to O&T and consultations from other services is higher in IP than the LP. Increasing physicians' awareness of cultural differences and expectations and providing health education to immigrant families through professional translators in their preferred language can diminish the load on healthcare.

Anahtar Kelimeler

Children, health, immigrant, orthopedic and traumatology, refugees

Proje Numarası

yok

Kaynakça

• 1. Kroening ALH, Dawson-Hahn E. Health Considerations for Immigrant and Refugee Children. Adv Pediatr. 2019; 66:87-110. (doi: 10.1016/j.yapd.2019.04.003).
• 2. Mcauliffe M, Trıandafyllıdou A (EDS.). World migration re-port 2022. International organization for migration, 2021;Geneva. www.worldmigrationreport.iom.int/wmr-2022-interactive/.
• 3. Reuters: “Turkey Spent $7.6 billion hosting 2.2 million Syrian Refugees.”, 2015. www.reuters.com/article/us-mideast-migrants-turkeyidUSKCN0RI0N720150918.
• 4. Kohler R. Nicolas Andry de Bois-Regard (Lyon 1658-Paris 1742): the inventor of the word "orthopaedics" and the fat-her of parasitology. J Child Orthop. 2010; 4(4):349-55. (doi: 10.1007/s11832-010-0255-9).
• 5. Palleiko BA, Lynn JV, Achkar AH, Hart-Johnson T, Perry MA, Blackwood RA. Sociodemographic Factors Associated With Adherence to Referrals From the Pediatric Emergency De-partment. J Emerg Med. 2020; 58(4):594-602. (doi: 10.1016/j.jemermed.2019.11.023).
• 6. Jalalvandi F, Arasteh P, Safari Faramani R, Esmaeilivand M. Epidemiology of Pediatric Trauma and Its Patterns in Wes-tern Iran: A Hospital Based Experience. Glob J Health Sci. 2015; 8(6):139-46. (doi: 10.5539/gjhs.v8n6p139).
• 7. Anantha RV, Zamiara P, Merritt NH. Surgical intervention in pediatric trauma at a level 1 trauma hospital: a retrospective cohort study and report of cost data. Can J Surg. 2018; 61(2):9817. (doi: 10.1503/cjs.009817).
• 8. Xu J, Chen X, Liu K, Guo G, Li Y. Health Service Utilization of International Immigrants in Yiwu, China: Implication for He-alth Policy. J Immigr Minor Health. 2021; 23(2):207-14. (doi: 10.1007/s10903-020-01066-7).
• 9. Sahin A, Agar A, Hancerli CO, Kilic B, Gulabi D, Erturk C. Epi-demiologic Study of Syrian Refugees Underwent Surgery Due to Fracture in a Tertiary Reference Hospital in Turkey. Cureus. 2021; 13(2):e13323. (doi: 10.7759/cureus.13323).
• 10. Duramaz A, Bilgili MG, Bayram B, Ziroğlu N, Bayrak A, Avkan MC. Orthopedic trauma surgery and hospital cost analysis in refugees; the effect of the Syrian civil War. Int Orthop. 2017; 41(5): 877-84. (doi: 10.1007/s00264- 016-3378-x).
• 11. https://www.fda.gov/medical-devices/products-and-medical-procedures.
• 12. Pottie K, Greenaway C, Hassan G, Hui C, Kirmayer LJ. Caring for a newly arrived Syrian refugee family. CMAJ.
• 2016; 188(3):207-11. (doi: 10.1503/cmaj.151422).
• 13. Ayanoglu T, Ataoglu MB, Tokgöz N, Ersöz E, Atalar H, Turanlı S. Assessing the risk of asymptomatic dysplasia in parents of children with developmental hip dysplasia. Acta Orthop Tra-umatol Turc. 2019;53(5):346-50. (doi:
• 10.1016/j.aott.2019.07.002).
• 14. Loder RT, Skopelja EN. The epidemiology and demographics of hip dysplasia. ISRN Orthop. 2011; 10:238607.
• (doi: 10.5402/2011/238607).
• 15. Dogruel H, Atalar H, Yavuz OY, Sayli U. Clinical examination versus ultrasonography in detecting developmental dyspla-sia of the hip. Int Orthop. 2008; 32(3):415-19. (doi: 10.1007/s00264-007-0333-x).
• 16. Regidor E, Sanz B, Pascual C, Lostao L, Sánchez E, Díaz Olalla JM. La utilización de los servicios sanitarios por la población inmigrante en España [Health services utilization by the im-migrant population in Spain]. Gac Sanit. 2009; 23 Suppl 1:4-11. Spanish. (doi: 10.1016/j.gaceta.2009.01.010).
• 17. Friedl NK, Muensterer OJ. Special Aspects in Pediatric Surgi-cal Inpatient Care of Refugee Children: A Comparative Co-hort Study. Children (Basel). 2019; 30;6(5):62. (doi: 10.3390/children6050062).
• 18. Bayrak A, Öztürk V, Koluman A, Ziroğlu N, Duramaz A. Injury characteristics and management of orthopaedic trauma in refugee children. Int Orthop. 2021; 45(3):649-56. (doi: 10.1007/s00264-021-04950-5).
• 19. Chen AH, Youdelman MK, Brooks J. The legal framework for language access in healthcare settings: Title VI and beyond. J Gen Intern Med. 2007; 22 Suppl 2(Suppl 2):362-67. (doi: 10.1007/s11606-007-0366-2).
• 20. Mendoza FS, Festa NK. New American children: supporting the health and well-being of immigrant populations. JAMA Pediatr. 2013; 167(1):12-3. (doi: 10.1001/jamapediatrics.2013.877).
• 21. Hagan JF Jr, Shaw JS, Duncan PM. Bright futures: guidelines for health supervision of infants, children, and adolescents. Elk Grove Village (IL): American Academy of Pediatrics 2017.
• 22. Muñoz-Pino N, Vives-Cases C, Agudelo-Suárez AA, Ronda-Pérez E. Comparing Oral Health Services Use in the Spanish and Immigrant Working Population. J Immigr Minor Health. 2018; 20(4):809-15. (doi: 10.1007/s10903- 017-0630-4).
• 23. Agudelo-Suárez AA, Muñoz-Pino N, Vivares-Builes AM, Ronda-Pérez E. Oral Health and Oral Health Service Utiliza-tion in Native and Immigrant Population: A Cross-Sectional Analysis from the PELFI Cohort in Spain. J Immigr Minor He-alth. 2020; 22(3):484-93. (doi: 10.1007/s10903-020-00972-0).
• 24. Newbold KB, Patel A. Use of dental services by immigrant Canadians. J Can Dent Assoc. 2006;72(2):143.
• 25. Svantner J, Dolci M, Heim C, Schoettker P. Pediatric Trauma: Six Years of Experience in a Swiss Trauma Center. Pediatr Emerg Care. 2021; 37(12):e1133-8. (doi: 10.1097/PEC.0000000000001925).
• 26. Singh O, Gupta S, Din Darokhan MAU, Ahmad S, Charak SS, Sen A. Epidemiology of Pediatric Musculoskeletal Injuries and Their Pattern in a Tertiary Care Center of North India. Indian J Orthop. 2018; 52(5):449-53. (doi: 10.4103/ortho.IJOrtho_516_17).
• 27. Sharma M, Lahoti BK, Khandelwal G, Mathur RK, Sharma SS, Laddha A. Epidemiological trends of pediatric trauma: A sing-le-center study of 791 patients. J Indian Assoc Pediatr Surg. 2011; 16(3):88-92. (doi: 10.4103/0971- 9261.83484).