Qualitative Pilot Study: Challenges for Primary Healthcare Providers Caring for Refugees in Northeast Ohio.

Background: Refugees resettling into the United States are faced with complex barriers to accessing basic health care. Qualitative research is needed from the primary health care providers' (PHCP) experience caring for refugees. Examination of PHCPs' experience adds to a holistic understanding of the healthcare needs of refugees and points to specific health system interventions to improve care. Consideration for Patient-Centered Medical Homes (PMCH) within refugee communities is advanced.  Objective: Gather experiences through narratives from PHCPs to understand challenges and barriers in meeting the health care needs of refugees and suggest solutions.  Design: Qualitative, descriptive framework. Open-ended, semi-structured interviews.

Participants:  In-depth interviews (n=seven) with current licensed PHCPs (four physicians and three family nurse practitioners) working in clinic practice settings throughout Northeast Ohio, providing care to four or more refugee families per week.  Approach: Interviews were recorded and transcribed. Transcripts were coded and analyzed utilizing thematic analysis to identify themes.

Key Results: Three themes related to challenges faced by PHCPs: 1) coordination and comprehensive care, 2) accessibility of services, 3) provision of patient-centered care.  Conclusions: The challenges PHCPs describe in delivering healthcare to refugee families were physical access to resources and care coordination. Support was found for inclusion of PCMH within refugee communities.