Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Tracy L. Rabin



HEALTHCARE IN THE UNITED STATES. Eunice M. M. DeFilippo, Amer Abdullah, Tracy L.

Rabin. Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.

As refugee populations worldwide increase exponentially, there is growing concern for the health needs of these displaced individuals. This qualitative study examines the illness experiences of newly arrived Syrian refugees as they navigate the complex U.S. healthcare system, in an attempt to identify and characterize potential barriers to care that can be addressed. The specific aims of this study are to understand the experiences, beliefs, and practices regarding general health and healthcare delivery amongst newly arrived Syrian refugees obtaining care at Yale New Haven Hospital. Twenty individuals were recruited to participate in semi-structured interviews. An Arabic language interpreter was present. Interviews were audio-taped, transcribed, and coded by a multidisciplinary team using grounded theory and analyzed for emergent themes. Participant ages ranged from 20-64; nine were female. Preliminary analysis of five transcripts revealed the

following major theme: Unmet expectations for healthcare delivery and patient-provider interactions leads to experiences of perceived healthcare system inaccessibility and insufficiency. Participants described frustration with: 1) Lengthy Wait Times for Care, 2) Prescription Requirements, 3) Delayed Access to Specialists, 4) Dismissed Chronic Complaints, and 5) Language Barriers. Unexpected shifts in care delivery also contributed, such as a lack of knowledge to understand the 1) Referral System, 2) Prescription Drug System, or their 3) Insurance Limitations. As a result, participants experienced delays in care leading to 1) Frustration, 2) Mistrust, and the 3) Reliance on Traditional Medicines. This preliminary analysis reveals key challenges to accessing the U.S. healthcare system and limitations in refugee-provider interactions that may contribute to patients disengaging from care, and are critical to address in efforts to improve care for this population.


This is an Open Access Thesis.

Open Access

This Article is Open Access