Use of hospitals and homelessness services by refugees and humanitarian entrants

Key findings

Cohort demographics

A small proportion of people are aged over 60 in the migrant cohorts; as of December 2020, only 9.2% of humanitarian entrants and 6.8% of other permanent migrants were aged over 60 in 2020–21, compared with 22% of the general Australian population, excluding Western Australia and the Northern Territory (ABS 2021). Further details about the data sources and who is included in the data, are in the Technical notes.

Hospital services

Humanitarian entrants were almost twice as likely to be hospitalised or attend an emergency department (ED) as other permanent migrants in the period 2016–17 to 2020–21 (243 hospitalisations and 293 ED presentations per 1,000 people in humanitarian entrants, compared with 135 hospitalisations and 149 ED presentations per 1,000 people in other permanent migrants).

Most common reasons for hospitalisations and emergency department presentations

Childbirth was the most common reason for hospitalisation in humanitarian entrants (8%) and other permanent migrants (12%) in 2020–21. Pain-related reasons, including pain in the throat or chest and pain in the abdomen were common reasons for ED presentations in both cohorts, consistent with top reasons for ED admissions in the general Australian population (AIHW 2021).

Emergency department presentations

In 2020–21, the rate of ED presentations in humanitarian entrants (289 per 1,000 people) was higher than for other permanent migrants (246 per 1,000). However, the proportion of total ED presentations that were classified as lower urgency care was lower in humanitarian entrants (32%) compared with other permanent migrants (42%) in 2020–21.

Across the period 2016–17 to 2020–21, a higher proportion of humanitarian entrants (28.5% in 2020–21) arrived to an ED via ambulance than other permanent migrants (15.6% in 2020–21). In 2020–21, 29% of humanitarian entrants arrived at an ED by ambulance; this was similar to the general Australian population (27%) (AIHW 2021) but higher when compared with of other permanent migrants (16%).

Injuries

In 2020–21, injuries amongst humanitarian entrants resulted in 53.6 ED presentations per 1,000 people and 16.8 hospitalisations per 100,000 people. Falls, contact with objects and transport accidents were the three most common reasons for injury-related hospitalisations amongst humanitarian entrants. Assaults caused a higher rate of injury-related hospitalisations among humanitarian entrants (1.9 per 1,000 people) than other permanent migrants (0.3 per 1,000 people). In comparison, the published rate of injury-related hospitalisations due to assault in the general Australian population is 0.9 per 1,000 people (AIHW 2024). 

Of all injury-related hospitalisations in humanitarian entrants, 7.4% were due to injuries that occurred whilst working, compared with 9.0% of injury-related hospitalisations in other permanent migrants. This difference may potentially be related to lower employment rates in humanitarian entrants (43%), compared with other permanent migrants (81% of skilled migrants and 62% of family migrants) (ABS 2023).

Homelessness services

One in eight (13%) of the total humanitarian entrant population were specialist homelessness services (SHS) clients at any point in the period, between 1 July 2011 to 30 June 2021, compared with 1 in 50 of the other permanent migrant populations. Almost three in five (58%) humanitarian entrant SHS clients were female, compared with almost 3 in 4 (73%) other permanent migrant SHS clients, and 22% of humanitarian SHS clients were under the age of 18 when they first received services, compared with 14% of other permanent migrant SHS clients.

For humanitarian entrants, accommodation was the main reason for seeking assistance from a SHS (40%) followed by Interpersonal issues (24%); with family and domestic violence the most common main (interpersonal) reason (18%).

The most common services needed by humanitarian entrant SHS clients were accommodation services (86% - which include short-term or emergency, medium-term or transitional, and long-term housing) and general services (87% - which include advice and information, material aid, meals and living skills). In almost 1 in 6 support periods (16%), humanitarian entrant clients needed a domestic violence service and in almost 1 in 7 (14%) needed immigration or cultural services. A ‘support period’ is the period of time a client receive services from a SHS agency. A client may have multiple support periods if they receive SHS services on multiple occasions.

For more detailed data including for other permanent migrants, refer to the Data tables.

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