PM3026: Feasibility Study of a Pilot Clinical Program for Newcomer Children with Special Health Care Needs

Background: Canada, especially large urban centers, have seen increasing numbers of refugees, many of whom are children. In our previous work, we found that there were no clinical programs for newcomer children with special healthcare needs (NCSHN) in our region, and identified key components that are needed to best support this population (Rizwan et al., 2020). Based on these criteria, we developed a pilot multidisciplinary clinic for NCSHN that launched in March 2019 and operated bi-weekly. This study examined the feasibility of the implementation of this clinical program.

Methods: For this feasibility study, we conducted a retrospective chart review of all patients referred to the clinic for NCSHN between its opening in March 2019 and April 2021. NCSHN were defined as having arrived in Canada less than 5 years ago as permanent residents, resettled refugees or asylum seekers, or being born to a parent who had arrived less than 5 years ago. Chart review information was gathered on referral source, diagnosis, access to primary care, social determinants of health as well as key demographic variables. Data was summarized using descriptive statistics.

Results: A total of 87 patients were referred to the clinic between March 2019 and April 2021. Of these, 71 (82%) attended an appointment; and of these, 80% were booked for follow-up visits. Most patients (72%) were seen by the MD and another provider. 38% did not have a regular primary care provider. Most (94%) identified as racialized and 37% of families required interpretation. The most common reason for referral was neuro-developmental concerns (43%), followed by genetic conditions (11%) and primary care needs (10%). Families reported higher rates of food insecurity (31%) and financial insecurity (44%), compared to baseline city rates of 18.5% and 17.6% respectively. Nearly 1 in 4 children (24%) were referred to our service navigation program for children with developmental or mental health needs, and 73% were connected to community and social services, such as daycare, income support and additional funding applications, housing services and immigration assistance.

Conclusion: Our study showed that our pilot model of care was implemented successfully, with high clinic attendance. A significant proportion did not have any primary care. The majority of the patients demonstrate high social needs and neuro-developmental concerns. Our clinic design may serve as a template model of care for newcomer children with special health care needs for implementation in other settings.