Abstract
Background: Accessing and using health care in European countries pose major challenges for asylum seekers and refugees due to legal, linguistic, administrative, and knowledge barriers. This scoping review will systematically describe the literature regarding health care for asylum seekers and refugees in high-income European countries, and the experiences that they have in accessing and using health care. Methods: Three databases in the field of public health were systematically searched, from which 1665 studies were selected for title and abstract screening, and 69 full texts were screened for eligibility by the main author. Of these studies, 44 were included in this systematic review. A narrative synthesis was undertaken. Results: Barriers in access to health care are highly prevalent in refugee populations, and can lead to underusage, misuse of health care, and higher costs. The qualitative results suggest that too little attention is paid to the living situations of refugees. This is especially true in access to care, and in the doctor-patient interaction. This can lead to a gap between needs and care. Conclusions: Although the problems refugees and asylum seekers face in accessing health care in high-income European countries have long been documented, little has changed over time. Living conditions are a key determinant for accessing health care.
Highlights
Asylum application numbers peaked in 2015 and 2016, when more than 2.5 million people applied for asylum in the European Union (EU) [1]
Two studies evaluated the financial burden of the health care systems used by refugees and asylum seekers [23,24]
Access to the health care system has primarily been subject to formal legal barriers [7]
Summary
Asylum application numbers peaked in 2015 and 2016, when more than 2.5 million people applied for asylum in the European Union (EU) [1]. When migration trajectories across Europe are considered, there are specific challenges in arrival, transit, and destination countries, such as a lack of coordination between health care providers in arrival countries, a short length of stay in transit countries, and missing social support in destination countries [5]. It is hard for refugees and asylum seekers to receive specialised care whilst in different migration phases [4,5]
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