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Introduction Childhood care by its nature requires the integration of nurturing and protective services [1]. Furthermore, a lack of appropriate resources tackling the specific needs of migrants and refugees has put pressure on health care services [2]. In this regard, the European project EUVETCARE qualitatively explores how to strengthen care delivery for child migrants and refugees. Methods Between April and May of 2019, a total of 99 professionals involved in the health and social care delivery for migrant minors as well as policy-makers participated in fifteen focus groups were carried out in 5 EU countries (Greece, Italy, Spain, Cyprus and Germany). FGDs were transcribed verbatim in local languages and transcriptions were analyzed using thematic analysis. Results Different gaps in knowledge were reported in the following topics: 1) Awareness and Knowledge of the political, social and health situation by origin country. 2) Cultural competence and social skills, to maximise the sensitivity of health care providers in the service of care to culturally diverse groups. 3) Legal, social, and medical services pertaining to migrants/refugee and how to facilitate the interconnectedness with them. Discussion Provision of health care to children is a right in EU regardless of any condition. However, the findings highlighted that this right may be not guaranteed in terms of quality and equality. Training of healthcare professionals doesn’t lead with psychosocial aspects of migration forgetting the cultural aspects of the minors and their families. Finally, the delivery of health care for minor migrants and refugees requires major intensity from the healthcare services. In this regard, there is a lack of procedures on how to involve other agencies, services and professionals to effectively manage cases of minor migrants and refugees. Conclusion Findings suggest that future training for healthcare professionals should guarantee both a holistic understanding of the health of these minors as well as better coordination of professionals and services with an interdisciplinary approach. Consequently, the training of healthcare professionals should target culturally-competent case management strategies for minor migrants and refugees. Lessons learned Future training for healthcare professionals will aim to develop culturally competent services achieving improved experiences of minor migrants and refugees by interdisciplinary and coordinated care. Limitations The sample of this study is not representative, which does not permit the extrapolation of results, nevertheless, this study allows to capture commonalities in 5 different European health care systems. Bibliography [1] Eastwood, J. Integrating Care for Children, Young People and Their Families. Int J Integr Care, 2018, 18(2): 20. [2] Puchner, K., Karamagioli, E., Pilouli, A., Tsiamis, C., Kalogeropoulos, A., Kakalou, E. et al. Time to Rethink Refugee and Migrant Health in Europe: Moving from Emergency Response to Integrated and Individualized Health Care Provision for Migrants and Refugees. International Journal of Environ. Res. Public Health. 2018, 15(6):1100.

In Spain, immigration flows and diversity are one of the most important social phenomena in the 21st century, representing great challenges for public administrations and societies. In this regard, one of the issues that concerns most is how to reduce inequalities between nationals and immigrants, in particular in terms of access and utilization of medical care services. According to WHO, social determinants of health refer to the “different conditions in which people are born, grow, work, live, and age” and “these circumstances are shaped by the distribution of money, power and resources at global, national and local levels”. Moreover, social determinants of health help to explain health inequalities among individuals, groups/communities and nations. Health disparities between immigrant population and locals are a result of numerous factors, such as lower economic status, worse working conditions, or a poorer access to care. When one or more members of a socially established group are being treated differently pejoratively because of his/her/their belonging to that group is defined as discrimination, being a determinant of health and health inequalities. The immigrant population is especially vulnerable to discrimination. Scientific evidence associates experiences of discrimination with worse self-perceived health, physical health, mental health problems, a higher prevalence of chronic diseases and substance use. This research aimed i at studying the experience of discrimination in the health care system among immigrants; and ii at examining how discrimination affects immigrants’ health status, by analysing the relationship between perceived discrimination, and self-related health status among immigrant groups’. A cross-sectional survey was conducted in a non-randomized sample of 100 immigrants. The health outcomes were measured by self-perceived health-related indicators and the reported discrimination was assessed by means of a set of questions asking immigrants about their discrimination experiences in the past five years. The preliminary results of this study show that over 60% of the participants have experienced a situation in which they felt discriminated. Men reported more discrimination due to their immigrant condition. Immigrants reporting discrimination also reported a significantly poorest health status than those not reporting discrimination. Moreover, mental health problems are related to discrimination due to immigrant status. The results of this research show that immigrant population’s perceived discrimination is related to worse perceived health status and mental health problems. Discrimination is a risk factor in immigrant population and could explain some health inequalities between immigrants and nationals. This study helps to characterize the correlation of discrimination and health in an immigrant group. The reinforcement of healthcare systems towards immigrants has to be the first step to reduce migration-related inequities in health and to ensure the effective application of human rights.

Introduction: Life expectancy has increased globally from 64 to 71 years. For many elderly people, hospitalization is followed by a fast decline of capacities and great mental challenges1. This progressive decline of the oldest age groups after hospitalization has triggered an increase in the prevalence of specific health and social conditions. Among these conditions, loneliness and cognitive impairment have been revealed among the most important causing dependency and re-hospitalization in elders2. In order to effectively address these issues, identifying frail elderly patients after hospitalization, and providing them with home-based care to fulfil their needs, may help to reduce readmissions at hospital facilities, and, thus, contribute to the sustainability of care systems as ultimate goal. Methodology – Intervention description: The intervention presented follows a holistic approach to hospital-at-home care, including the care of medical, social and psychological needs for elders. The intervention programme presented in this study targets older people aged 75 and above, who have been admitted at the hospital through the emergency department, and it starts after discharge from hospital to hospital-at-home. The programme is designed based on evidence, and is aimed to: 1 reduce loneliness and increase social participation; and 2 slow down the progressive cognitive impairment. As part of the intervention, the following care pathways are designed in order to complement the medical treatment and achieve the proposed aims: A motivational-based care pathway developed by social workers. This care pathway is intended to motivate the patient to take part in the community, based on patient’s personal likes, being the ultimate goal to reduce loneliness. The planned structure for this care pathway is a monthly face-to-face interview and telephone follow-up, in which the patient and the social worker check the accomplishment of a set of objectives and measures they have agreed-upon. A cognitive impairment care pathway guided by psychologists. This care pathway is based on attention and memory training for those patients suffering from mild cognitive impartment. The training is delivered using a workbook including a set of exercises to train cognitive strategies. The planned structure for this care pathway is performed by a psychologist by means of a face-to-face interview and two telephone interviews per month. Conclusion: The proposed intervention programme follows a population-oriented approach focus on each patient needs. The two care pathways on which this programme is based on provide a complementary intervention to medical care, ensuring that psychological and social aspects are also covered as a part of holistic healthcare delivery. This intervention offers an innovative care strategy of integrated care for those patients receiving hospital-at-home care. References: 1- Hengartner MP, Klauser M, Heim G, Passalacqua S, Andreae A, Rossler W, et al. Introduction of a Psychosocial Post-Discharge Intervention Program Aimed at Reducing Psychiatric Rehospitalization Rates and at Improving Mental Health and Functioning. Perspect Psychiatr Care. 2017 Jan 1;531:10–5. 2- Boaz TL, Becker MA, Andel R, McCutchan N. Rehospitalization risk factors for psychiatric treatment among elderly Medicaid beneficiaries following hospitalization for a physical health condition. Aging & Mental Health. 2017 Mar 4;213:297–303.