Use of hospitals and homelessness services by refugees and humanitarian entrants

In 2020–21, humanitarian entrants were most commonly hospitalised for: 

1. Unassisted vaginal birth of a single baby (single spontaneous delivery) (10 people hospitalised per 1,000 people, specifically 20 females hospitalised per 1,000 females)
2. Abdominal and pelvic pain (7.3 people hospitalised per 1,000 people)
3. Birth of a single baby via caesarean section (single delivery by caesarean section) (6.9 people hospitalised per 1,000 people, specifically 14 females per 1,000 females) (Figure 4).

In 2020–21, the highest number of hospitalisations (episodes of care) for both humanitarian entrants and other permanent migrants was for care involving dialysis. However, as most people undergoing dialysis attend three sessions per week (ANZDATA 2021), the total number of hospitalisations for dialysis relate to a relatively small number of people (103 humanitarian entrants in 2020–21) (Figure 5). Further details of the most common reasons for hospitalisation, including disaggregation by gender are in Data tables and Figure 4.

Figure 4: Top 10 most common principal diagnoses by number of hospitalisations and number of people with a hospitalisation, by cohort, by sex, 2020–21

Notes:

1. Primary diagnosis is the first listed diagnosis on the hospitalisation record.
2. Rate of hospitalisations is the number of hospitalisations per 1,000 people. Rate of people hospitalised is the number of people who were hospitalised in that financial year for the specified reason, this will only count each person once in each diagnosis category- even if they are hospitalised on multiple occasions in a financial year for the same specific principal diagnosis.
3. Principal diagnosis is based on the ICD-10-AM (11^th Edition). Group labels have been edited for length and clarity, see Technical notes for further details on the classification system.
4. This analysis excludes people who lived in WA or NT or had hospitalisations in WA or NT.

In 2020–21, the two leading causes of ED presentations for humanitarian entrants and other permanent migrants were pain in the abdomen, and pain in the throat or chest (Figure 5).

In the same time period, the fourth most common reason for ED presentations in other permanent migrants was special screening examination for COVID-19 but it was not in the top 20 reasons for humanitarian entrants.

Figure 5: Top 10 most common principal diagnoses by number of emergency department presentation and number of people with an emergency department presentation, by cohort, by sex 2020–21

Notes:

1. Primary diagnosis is as described in the ED ICD-10-AM principal diagnosis short list (11^th edition).
2. Rate of ED presentations is the number of ED presentations per 1,000 people. Rate of people who presented to an ED is the number of people who presented to the ED in that financial year for the specified reason, this will only count each person once in each diagnosis category- even if they attend an ED on multiple occasions in a financial year for the same specific principal diagnosis.
3. Principal diagnosis is based on the primary diagnosis information coded to the ED ICD-10-AM (11^th edition) principal diagnosis short list. Group labels have been edited for length and clarity, see Technical notes for further details on the classification system.
4. This does not include emergency department presentations which occurred in WA or NT or in people living in WA or NT.

There are different reasons for hospitalisations and ED presentations by age (AIHW 2023). Variations in the top reasons for hospitalisations and ED presentations between these migrant cohorts and data reported for the general population may be due to the age structure of the populations and include:

• less hospitalisations for cancer and chronic health conditions
• headache featuring in the top 20 for humanitarian entrants and other permanent migrants but not in the top 20 for the general Australian population (AIHW 2023). 

For more detailed data, including the top 20 reasons for ED presentations and hospitalisations and hospitalisations by ICD-10-AM chapters from 2016–17 to 2020–21, refer to the Data tables.