Methods of Accessing Care Among Nepali and Burmese Refugee Communities in Philadelphia: The Refugee Narrative as a Qualitative Study

There is a lack of information available on resettled refugee access to health care in the United States. In particular, there is a lack of literature on the Refugee Medical Assistance (RMA) program, a fact that was also identified by refugee resettlement organizations in the Philadelphia area. Although it is believed that refugees whose RMA has expired are re-evaluted and qualify for other medical assistance programs, there is no data to support that model. As a result, little information is known regarding health care access practices among resettled refugees who are beyond the intensive 4-6 month initial resettlement period. Similarly, very little literature exists regarding the refugee experience and perceptions regarding health care access in the United States. The majority of the literature that is available is targeted largely to physicians, or to a specific refugee group or medical problem; thus, there is a general lack of information on refugee-reported themes and perceptions about access to health care. The purposes of this study were twofold: to identify the refugee-reported themes in accessing health care among resettled refugees in Philadelphia, and to identify the methods utilized by the resettled refugee community for accessing health care in Philadelphia, particularly after the expiration of the Refugee Medical Assistance benefit. We conducted guided, open-ended interviews with 18 resettled refugees about barriers and facilitators to accessing care, past and present health insurance status, perceived health norms, access to care norms, and their experiences and narrative history in accessing care in Philadelphia.