Healthcare access dynamics and characteristics of foreign nationals using emergency departments: A retrospective study from Türkiye

Abstract

Background/Objectives: Türkiye is located at the intersection of major international migration routes and plays a critical role in global migrant health. The growing immigrant and refugee population has introduced new challenges to healthcare systems (HCSs), particularly in emergency departments (EDs). This study aims to address a gap in the literature by evaluating the reasons foreign nationals present to the ED, their diagnostic distribution, and access to healthcare services in relation to sociodemographic characteristics. Methods: This retrospective study included foreign nationals who presented to the Emergency Department of Balikesir University Hospital between January 2020 and June 2025. Sociodemographic and clinical data were obtained from the hospital information management system. Data analysis was performed using IBM SPSS Statistics 27.0. Descriptive statistics were used to summarize demographic and clinical characteristics, including gender, nationality, admission period, diagnosis groups, laboratory testing, consultations, and patient outcomes. Results: A total of 6366 foreign nationals were included. Of these, 66.4% were female and 33.6% were male, with a mean age of 31.9 years for females and 26.8 years for males. Syrians constituted the largest group (50%). ED visits occurred most frequently in spring (30.1%) and peaked in 2024. The majority of patients (99.3%) were managed as outpatients. The most common diagnoses were internal medicine-related conditions (36.1%) and genitourinary emergencies (32.2%). Consultations were most frequently requested from the obstetrics and gynecology department (21.2%). Overall, 92.9% of patients were discharged from the ED. Conclusions: The findings suggest that foreign nationals often use emergency services as an alternative to primary healthcare. Low rates of laboratory and imaging utilization indicate that most ED visits were for non-urgent and uncomplicated conditions. Factors such as language barriers, communication difficulties, prolonged observation times, and limited social support may contribute to this pattern. This study provides comprehensive local data on the emergency care utilization of foreign nationals in Türkiye and offers valuable insights for healthcare planning and policy development.