Mortality risk estimation for autistic older adults: comparing novel machine-learning derived weights versus standard weights for the Charlson Comorbidity Index.
Authors: Blake M, Nikahd M, Hyer JM, Patterson BW, Wolf BJ, Bishop L, Hand BN
Journal: Journal of comparative effectiveness research
mental health
psychology
open access
Abstract
Forced displacement has increased markedly over the past decade due to armed conflict, persecution, and human rights violations. According to the United Nations High Commissioner for Refugees (UNHCR), more than 120 million people worldwide were forcibly displaced by the end of 2024, highlighting the sustained and global nature of the migration and refugee crisis (UNHCR, ). Within Europe, Greece has remained a frontline country since 2015, facing ongoing challenges in providing adequate healthcare services to refugee and asylum-seeking populations, particularly in reception and camp settings (Gunst ., ). It is noted that refugees and asylum seekers commonly experience significant barriers to accessing healthcare, including administrative obstacles, fragmented services, and communication difficulties (Morris ., ; Robertshaw ., ; Sherif ., ). These challenges are particularly pronounced in maternity care, where effective communication, continuity, and trust are critical to clinical safety and quality. Evidence from Greece and other host high-income countries (HICs) indicates that language barriers, limited availability of interpreters, and cultural distance can compromise access to timely and appropriate perinatal care (Betancourt
; Alizadeh and Chavan, ; Al Shamsi ., ; Scott and Wallis, ). Many researchers highlight how refugee women are at increased risk of adverse maternal and perinatal outcomes, including stillbirth, preterm birth, and selected pregnancy-related complications, compared with host populations in HICs (Carolan, ; Harakow ., ). Delayed initiation of antenatal care and reduced engagement with maternity services have been consistently associated with lack of familiarity regarding host-country healthcare systems, cultural differences, and communication barriers. In camp-based settings, these risks are further intensified by resource constraints and disrupted care pathways (Kentoffio ., ). In the Greek camp context, care was commonly provided through primary care walk-in clinics (PCWCs ) located within refugee camps, where midwives offered assessment without appointment requirements (Gunst , ; Scott and Wallis, ).
; Alizadeh and Chavan, ; Al Shamsi ., ; Scott and Wallis, ). Many researchers highlight how refugee women are at increased risk of adverse maternal and perinatal outcomes, including stillbirth, preterm birth, and selected pregnancy-related complications, compared with host populations in HICs (Carolan, ; Harakow ., ). Delayed initiation of antenatal care and reduced engagement with maternity services have been consistently associated with lack of familiarity regarding host-country healthcare systems, cultural differences, and communication barriers. In camp-based settings, these risks are further intensified by resource constraints and disrupted care pathways (Kentoffio ., ). In the Greek camp context, care was commonly provided through primary care walk-in clinics (PCWCs ) located within refugee camps, where midwives offered assessment without appointment requirements (Gunst , ; Scott and Wallis, ).