Improving delivery of primary care for vulnerable migrants Delphi consensus to prioritize innovative practice strategies

• Published in: Canadian family physician 2014-01, Vol.60 (1), p.e32-e40
• Main Authors: Pottie, Kevin, Batista, Ricardo, Mayhew, Maureen, Mota, Lorena, Grant, Karen
• Format: Article
• Language: English
• Subjects: Adult; Canada; Consensus; Delivery of Health Care - methods; Delphi Technique; Emigrants and Immigrants; Family physicians; Female; Humans; Male; Middle Aged; Noncitizens; Primary care; Primary Health Care - methods; Quality Improvement; Refugees; Vulnerable Populations
• ISSN: 0008-350X; 1715-5258

To identify and prioritize innovative strategies to address the health concerns of vulnerable migrant populations. Modified Delphi consensus process. Canada. Forty-one primary care practitioners, including family physicians and nurse practitioners, who provided care for migrant populations. We used a modified Delphi consensus process to identify and prioritize innovative strategies that could potentially improve the delivery of primary health care for vulnerable migrants. Forty-one primary care practitioners from various centres across Canada who cared for migrant populations proposed strategies and participated in the consensus process. The response rate was 93% for the first round. The 3 most highly ranked practice strategies to address delivery challenges for migrants were language interpretation, comprehensive interdisciplinary care, and evidence-based guidelines. Training and mentorship for practitioners, intersectoral collaboration, and immigrant community engagement ranked fourth, fifth, and sixth, respectively, as strategies to address delivery challenges. These strategies aligned with strategies coming out of the United States, Europe, and Australia, with the exception of the proposed evidence-based guidelines. Primary health care practices across Canada now need to evolve to address the challenges inherent in caring for vulnerable migrants. The selected strategies provide guidance for practices and health systems interested in improving health care delivery for migrant populations.