TY - JOUR
T1 - Health service utilization and adherence to medication for hypertension and diabetes among Syrian refugees and affected host communities in Lebanon
AU - The Lebanon Health Access Survey (LHAS) Study Team
AU - Lyles, Emily
AU - Burnham, Gilbert
AU - Chlela, Lara
AU - Spiegel, Paul
AU - Morlock, Laura
AU - Doocy, Shannon
AU - Aridi, Nour
AU - Kassab, Nour
AU - Keyrou, Aline
AU - Sibai, Abla
AU - Fouad, Fouad
AU - Al-Shatti, Deena
AU - de La Roche, Francois
AU - Woodman, Michael
N1 - Funding Information:
This study was funded by the European Commission Humanitarian Aid and Civil Protection Department (grant number ECHO/SYR/BUD/2014/91025). Acknowledgements
Funding Information:
The study was implemented by The Center for Humanitarian Health at Johns Hopkins School of Public Health (JHSPH) and Médecins du Monde (MdM). Administrative and technical support was provided by International Medical Corps, The American University of Beirut Faculty of Health Sciences, and the United Nations High Commissioner for Refugees (UNHCR). We would like to extend our gratitude to the MdM interviewers, without whom this work would not have been possible. In addition, we would like to express our gratitude to William Weiss, Timothy Roberton, Tyler Alvare, Lee Bone, Kenneth Shermock, and many other colleagues at the Johns Hopkins School of Public Health for their contributions to this work. We are also grateful to Adam Coutts for his review of the questionnaire and for facilitating partnership between the different organizations. Finally, we would like to acknowledge Rick Brennan, Claudine Prudhon, Altaf Musani, and Alissar Rady, from WHO and Marian Schilperoord and Frank Tyler from the UNHCR for their support and efforts to facilitate the survey. This work was supported by the European Commission Humanitarian Aid and Civil Protection Department [grant number ECHO/SYR/BUD/2014/91,025]. The LHAS Study Team: The Lebanon Health Access Study Team includes Nour Aridi, Nour Kassab, and Aline Keyrouz from Médecins du Monde; Abla Sibai and Fouad Fouad from the Faculty of Health Sciences at American University of Beirut, Deena Al-Shatti and Francois de La Roche from International Medical Corps, and Michael Woodman from the United Nations High Commissioner for Refugees.
Publisher Copyright:
© 2020, Springer Nature Switzerland AG.
PY - 2020/12
Y1 - 2020/12
N2 - Methods: This study uses data from a 2015 household survey of Syrian refugees and Lebanese host communities. A total of 1,376 refugee and 686 host community households were surveyed using a cluster design with probability proportional to size sampling. Differences in outcomes of interest by population group were examined using Pearson’s chi-square and t-test methods and the crude and adjusted odds of care-seeking and interrupted medication adherence among Syrian refugees were estimated using logistic regression. Results: Findings identified significant gaps between refugees and host community members in care-seeking, health facility utilization, out-of-pocket payments for care, and medication interruption. While host community members had better access to care and fewer reports of medication interruption compared to refugees, out-of-pocket spending for the most recent care visit was significantly higher among host community care-seekers. Refugee care-seekers most frequently received care at primary health facilities, choosing to do so mainly for reasons related to cost, whereas host community care-seekers predominantly utilized private clinics with greater concern for quality and continuity of care. Conclusion: Further efforts are needed to facilitate lower and more predictable health service costs for refugees and vulnerable host community members, as is continued communication on available subsidized care. Purpose: To characterize care-seeking, health service utilization and spending, and medication prescribing and adherence for hypertension and diabetes among Syrian refugees and host communities in Lebanon.
AB - Methods: This study uses data from a 2015 household survey of Syrian refugees and Lebanese host communities. A total of 1,376 refugee and 686 host community households were surveyed using a cluster design with probability proportional to size sampling. Differences in outcomes of interest by population group were examined using Pearson’s chi-square and t-test methods and the crude and adjusted odds of care-seeking and interrupted medication adherence among Syrian refugees were estimated using logistic regression. Results: Findings identified significant gaps between refugees and host community members in care-seeking, health facility utilization, out-of-pocket payments for care, and medication interruption. While host community members had better access to care and fewer reports of medication interruption compared to refugees, out-of-pocket spending for the most recent care visit was significantly higher among host community care-seekers. Refugee care-seekers most frequently received care at primary health facilities, choosing to do so mainly for reasons related to cost, whereas host community care-seekers predominantly utilized private clinics with greater concern for quality and continuity of care. Conclusion: Further efforts are needed to facilitate lower and more predictable health service costs for refugees and vulnerable host community members, as is continued communication on available subsidized care. Purpose: To characterize care-seeking, health service utilization and spending, and medication prescribing and adherence for hypertension and diabetes among Syrian refugees and host communities in Lebanon.
KW - Adherence
KW - Health care utilization
KW - Lebanon
KW - Refugee health
KW - Syria
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U2 - 10.1007/s40200-020-00638-6
DO - 10.1007/s40200-020-00638-6
M3 - Article
C2 - 32963978
AN - SCOPUS:85092012141
SN - 2251-6581
VL - 19
SP - 1245
EP - 1259
JO - Journal of Diabetes and Metabolic Disorders
JF - Journal of Diabetes and Metabolic Disorders
IS - 2
ER -