Providing Health Services to Migrants and Refugees Settling in Victoria, Australia: An Analysis of the Complexity, Cost and Policy Implications for Public Health

The aim of the research was to identify factors related to the increased cost of providing health services to clients from a nonEnglish speaking background (NESB), using a crosssectional analysis of the administrative records of clients using community health services in the Northern Metropolitan region of Melbourne for the 2001/2002 financial year. The higher cost of providing services to NESB clients was influenced by four factors: increased consultation time, group attendance to an appointment, increased interpreting cost and the type of service provider. Family members and multilingual staff play a significant role in providing informal interpreting services or lowcost support for NESB consultations, and these activities should receive appropriate support. Additional funding is needed to support interpreting requirements when dealing with the health needs of NESB clients. Vertical funding equity would provide a better solution than the current horizontal equalisation funding.