Promoting longitudinal healthcare access for immigrants: Retrospective analysis of a free clinic serving Arizona refugees

Background: Refugee, immigrant, and asylee populations face significant barriers to healthcare access, including linguistic, cultural, socioeconomic, and institutional challenges. The Refugee Education and Clinic Team (REACT) is a student-run free clinic in Maricopa County, Arizona, providing subacute care and referrals to federally qualified health centers (FQHCs). This study evaluates patient demographics, clinical needs, social determinants of health (SDH), and follow-up outcomes to identify barriers to long-term care integration. Methods: A retrospective chart review of all REACT patients (2022–2024) was conducted using electronic health records. Data on demographics, SDH, chief complaints, prescriptions, referrals, and follow-up outcomes were analyzed using descriptive statistics and logistic regression. Results: The cohort (n=95) was predominantly uninsured (63%) and faced significant social barriers, including food insecurity (30.5%), employment challenges (30.5%), and language barriers (28.4%). Musculoskeletal pain and general health check-ups were the most common concerns. Older patients had higher-than-expected rates of possible hypertension. Nearly 90% received primary care provider (PCP) referrals, yet follow-up rates remained low, with only 42% attending or planning to still attend the referred visit after their initial clinic visit with us. Successful phone outreach was a significant predictor (OR: 0.5, 95% CI: 0.31-0.77) of PCP visit attendance by multivariate logistic regression. Conclusion: REACT serves a unique population with distinct barriers to care. While the clinic facilitates healthcare entry, limited follow-up adherence highlights the need for enhanced outreach, geographically optimized referrals, and integrated allied health services to improve care continuity.