Purpose. To describe a “medical home” for pediatric refugees and its ability to provide culturally competent care, to partner with and train medical interpreters, and to improve health screening and follow-up adherence rates of pediatric refugees immigrating to Rhode Island. Methods. A retrospective chart review of refugees was performed. Background information, initial laboratory data, whether patients completed the recommended follow-ups scheduled at 1, 3, 6, and 12 months, and completion of tuberculosis treatment were recorded. Results. Since its initiation, 104 refugee children have attended the clinic ranging in age from 5 months to 18 years. Since the initiation of the medical home for refugee children in 2007, initial screening rates have gone up to 99-100% compared to a low of 41% in 2003–2006 prior to the establishment of the medical home. There was a 43% reduction in missed appointments in 15-month follow-up. Conclusion. The refugee “medical home” allows refugees to benefit from a comprehensive system for disease detection and ongoing primary health care. 1. Introduction In 2010, 25,373 refugees under 18 years of age arrived in the United States (US), making up 35% of admitted refugees [1]. Refugees undergo medical screening overseas that focuses on medical eligibility for the US Refugee Program. After arrival to the USA, the Office of Refugee Resettlement requires refugees to receive a comprehensive physical exam within 30–60 days. Refugee children arriving to the USA typically present with high rates of health problems that differ drastically from those seen in the general population. These include high rates of preventable conditions and infectious diseases, poor immunization status, elevated blood lead levels, poor nutrition and growth, poor dental health, and mental health issues [2, 3]. From November 2003 to November 2006, 2% of refugee children arriving to Rhode Island were human immunodeficiency virus (HIV) positive, 5% were diagnosed with malaria, 10% had a positive hepatitis B surface antigen, 21% of patients who returned stool were positive for pathogenic parasites, 25% had elevated lead levels, and 28% had a positive PPD [4]. In spite of significant health needs, refugee children often lack access to coordinated and comprehensive screening and assessment. Linguistic barriers are apparent given the unfamiliarity of many refugees’ languages. Trained medical interpreters for languages such as Kirundi, Krahn, Kunama, Arabic, Swahili, Kinyarwanda, Nepali, Karen, Tigrinya, Wolof, and Sango are often difficult to access. In addition,
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