Providing health care to medically uninsured immigrants and refugees

D.A. Moutzouris, J. Droulias, E.E. Politis Nephrology Department, "Evangelismos" General Hospital, Athens, Greece

We agree with P.Caulford and Y. Vali1 that uninsured and refugees patients are undertreated. We’d like to share our experience regarding hemodialysis for this subset of patients. In Greece, uninsured patients with end stage renal disease can’t be registered to undergo regular hemodialysis. Nevertheless, since only emergent hemodialysis sessions are financially covered by the national health system, these patients are admitted as emergency cases and they undergo dialysis in the renal units of public hospitals. After the dialysis session, they are discharged. In Greece, a different hospital is on duty (outpatients emergency service) every day. Therefore, uninsured hemodialysis patients are treated in a different dialysis unit each time. Our unpublished date regarding this unique category of end stage renal disease patients show increased mortality (approaching 22% per dialysis year) in comparison with patients undergoing regular hemodialysis in our unit. This could be attributed to inefficient hemodialysis dose, lack of standard monitoring and drug administration. The above population includes unemployed natives, immigrants and refugees from several Balkan countries (Albania, Bulgaria, Romania etc), Asian countries (India, Pakistan) and African countries (Nigeria, Ivory Coast) etc. They represent a significant portion of the total nephrology admissions (reaching 19%) which increases dramatically each year. We believe that national and universal actions should be taken so the above population can be treated sufficiently and enjoy acceptable quality of life in their new countries.

Reference 1. Paul Caulford and Yasmin Vali Providing health care to medically uninsured immigrants and refugees CMAJ 2006; 174: 1253-1254

Conflict of Interest:

None declared