Aims and Objectives In today’s globalised world, the movement of people – or migration – to high-income countries has significantly increased. Health services in many receiving countries are not well prepared for the growing migrant population, and many migrants face poorer health outcomes than their host communities. This may be particularly significant in emergency care settings due to barriers migrant populations experience accessing health. Despite this, there is a lack of data on migrant use of emergency services in high-income countries. This systematic review aims to identify and synthesise data on patterns of emergency service use among migrants to Europe and North America to inform policies around migrant healthcare in the emergency department.

Method and Design A systematic search was conducted between January 1995 and May 2023 of Medline, Embase, Global Health and PubMed databases of literature reporting emergency service use among migrants to Europe and North America. Articles were screened by title and full-text. (PROSPERO CRD42016043682).

Results and Conclusion The review to date has identified 20 studies for inclusion. Data show emergency service use among migrants were comparable to non-migrants. Migrant emergency service attendees were less likely to be registered with a general practitioner than non-migrant patients, suggesting migrants may face additional barriers to accessing primary care services. Migrants were also more likely to report self-referral to emergency services rather than referral through primary care services.

These findings raise concerns about health inequities amongst migrant populations who self-refer to emergency care (bypassing preventative care and potentially at a late stage of illness) and the implications that use of emergency services for primary care needs may have for health systems. Considering increasingly restrictive health systems for migrants, the findings highlight that it is imperative to facilitate access to effective primary care for migrant populations, to reduce the risk of poorer and more costly health outcomes and the burden on emergency services.