Akademik Veri Yönetim Sistemi
European Journal of Emergency Medicine, 2026 (SCI-Expanded, Scopus)
Background – Understanding refugee emergency medical services (EMS) utilization patterns is critical for forecasting demand, optimizing triage, and planning route-adapted surge capacity in border regions. Van Province is Turkey’s border gateway on the Eastern Mediterranean migration route. Objective – This study aimed to quantitatively characterize refugee EMS utilization patterns and compare them with same-day randomly sampled citizen encounters along this migration route. Design, settings, and participants – A retrospective, observational cohort study of adult EMS encounters in Van Province was conducted for the years 2018–2024, using 1 : 1 same-day random sampling to select citizen controls. Refugee status referred to noncitizen patients presenting without official identification, corresponding to undocumented irregular migrants in the EMS registry. Outcomes measure and analysis – Primary outcomes were the distributions of mutually exclusive prehospital presentation categories derived from EMS-assigned International Classification of Diseases 10th Revision codes and clinical narratives. Associations with refugee status were assessed using logistic regression adjusted for age and sex. Main results – The analytic sample comprised 4924 encounters (refugees n = 2462 and citizens n = 2462). Refugees were younger (median 27 vs. 42 years) and more often male (63.6 vs. 39.5%). Rural scenes were more frequent (39.0 vs. 28.2%). Refugees had a greater trauma burden: traffic accidents [12.9 vs. 3.5%; adjusted odds ratio (aOR): 2.24, 95% confidence interval (CI): 1.71–2.94], other physical trauma (16.1 vs. 6.5%; aOR: 2.02, 95% CI: 1.62–2.51), cold-related emergencies (4.0 vs. 0.3%; aOR: 7.15, 95% CI: 3.21–15.90), and gunshot injuries (2.6 vs. 0.1%; aOR: 10.14, 95% CI: 3.05–33.63). Chronic presentations were lower: respiratory (5.3 vs. 14.1%; aOR: 0.58, 95% CI: 0.45–0.73) and cardiovascular (3.7 vs. 12.7%; aOR: 0.55, 95% CI: 0.42–0.72). Medico-legal cases were more common among refugees (22.0 vs. 5.0%; P < 0.001). Simple Triage and Rapid Treatment (START) triage distributions showed fewer green (57.6 vs. 62.9%) and more yellow (35.8 vs. 31.3%) among refugees; red was similar (5.1 vs. 5.2%), while black was higher (1.5 vs. 0.6%). Conclusion – Along this migration route, refugee EMS utilization showed a distinctly trauma-dominant pattern, marked by transport injuries, violence-related events, cold-exposure emergencies, and a higher burden of medico-legal presentations compared with citizens.