Abstract
In the wake of the European refugee crisis, Germany has received over a million new applications for asylum in the last two years. The health care system is struggling to provide asylum-seekers with access to essential medical services and facilitate their longer-term integration. In this article, we report on the morbidity, utilization and costs of care for a sample of asylum-seekers as compared to a matched group of regularly insured. Using administrative data, we found that asylum-seekers had more hospital and emergency department admissions, including more admissions that could be avoided through good outpatient care or prevention. Their average expenditures were 10 percent higher than for the regularly insured, mostly because of higher hospital expenditures, although there was substantial variation in expenditures by country of origin. Facilitating access to the health care system, especially outpatient and mental health care, could improve asylum-seekers health status and integration, possibly at lower costs.
Highlights
Germany is struggling to integrate the recent influx of migrants, many of whom apply for asylum
We constructed a matched comparison group of 18,191 individuals who were regularly insured through the BARMER health plan in 2016
We found that the recent wave of asylum-seekers has different morbidity, utilization and cost profiles than a matched comparison group of regularly insured
Summary
Germany is struggling to integrate the recent influx of migrants, many of whom apply for asylum This is a challenge to the health care system. Refugees and asylum-seekers are granted access to medical care services by international law and, in the case of Germany, by European Union directives and the German Constitution. Beyond these legal requirements, providing good access to the regular health care system can help ameliorate acute, chronic and preventable conditions, and thereby improve individuals’ health status, lower medium-term health care spending, and facilitate overall integration [2,3]. The majority of recent arrivals comes from Syria, Afghanistan or Iraq
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