# Barriers and facilitators to refugees, asylum seekers and people experiencing homelessness accessing non hospital based care: A mixed methods systematic review protocol

## TL;DR

This study aims to understand what stops or helps socially excluded groups like refugees and homeless people from accessing non-hospital healthcare.

## Contribution

The study introduces a mixed methods systematic review protocol to explore barriers and facilitators for marginalized groups accessing non-hospital care.

## Key findings

- People from socially excluded groups often rely on emergency hospital care due to limited access to non-hospital services.
- Little is known about the specific barriers and facilitators these groups face in accessing non-hospital healthcare.
- The study will synthesize both quantitative and qualitative data to better understand healthcare access for marginalized populations.

## Abstract

Context: Social exclusion is characterised by and represents a form of disadvantage and marginalisation of vulnerable groups of people in society, who cannot fully participate in the normal activities of daily living. Socially excluded groups consist of, but are not limited to the following groups: people experiencing homelessness, asylum seekers and refugees. People from socially excluded groups have complex healthcare needs including infectious and non-communicable diseases. People from socially excluded groups tend to present more to the acute hospital setting as emergency presentations. Little is known about barriers and facilitators experienced by these groups to accessing non hospital based care.

Objectives: This mixed methods systematic review, will critically examine the concept of barriers and facilitators for refugees, asylum seekers and people experiencing homelessness, to accessing non hospital based care.

Methods: This methodological review will follow the Joanna Briggs Institute guidance for conducting mixed methods reviews. The following databases will be searched: Central Medline, PubMed, Embase, CINAHL, and the Cochrane Library. Relevant grey literature will be included. Title and abstract screening, followed by full-text screening will be undertaken independently by two reviewers. The Joanna Briggs Institute extraction tool will be adapted for data extraction.

Discussion: This mixed method review will comprehensively evaluate quantitative and qualitative data, synthesise both barriers and facilitators and follow a systematic approach through establishing use of mixed methods research across a number of marginalised groups, and how they affect accessing non hospital based care. It will explore conceptual models of access to healthcare and how they influence these factors.