Abstract
Nation-wide studies on the health care situation of asylum-seekers in Germany are lacking, but decision-makers increasingly need such information. The aim of the study was to assess structures, processes and needs related to the health care provision for asylum-seekers along the continuum of reception centres to community dwellings from the perspective of the German public health authorities. A nation-wide cross-sectional mixed-methods survey was carried out. All heads of public health authorities in Germany (N= 389) were invited to complete astandardized questionnaire related to: (1) medical procedures and screening; (2) prevention and health promotion; (3) communication; (4) documentation and information; (5) coordination; (6) structural resources and needs. The quantitative survey was complemented by qualitative semi-structured interviews. In total, 123heads of public health authorities (response rate: 31,6 %) completed the questionnaire, and 29 were interviewed. Priority areas to improve the health care situation were better coordination and standardisation of care, enhancing vaccination capacities, standardised documentation, better health information exchange (in line with data protection laws), and astronger focus on afew relevant infectious diseases in the scope of compulsory health entry examinations. The instruments proved useful to assess the health care situation of asylum-seekers in adecentralized health care system. Repeated surveys with afocus on selected domains of the questionnaire could help monitor the health care situation on aregular basis.
Highlights
Nation-wide studies on the health care situation of asylum-seekers in Germany are lacking, but decision-makers increasingly need such information
processes and needs related to the health care provision for asylum-seekers
Humanitäre Charta und Mindeststandards in der humanitären Hilfe
Summary
Zusätzliche Informationen sind in der Online-Version dieses Artikels (DOI: 10.1007/ s00103-016-2329-4) enthalten. Die Ausgestaltung der primären gesundheitlichen Versorgung von Asylsuchenden in Deutschland beruht auf föderalen Bestimmungen. Darüber hinausgehende Aspekte der gesundheitlichen Versorgung sind in den §§ 4 und 6 des Asylbewerberleistungsgesetzes geregelt. Angesichts einer zunehmenden und hohen Anzahl von Asylsuchenden und Flüchtlingen im Jahr 2015 bestand auf Seiten von Entscheidungsträgerinnen und -trägern in Bundesministerien und weiteren Behörden einerseits Handlungsbedarf, geeignete Maßnahmen zur Verbesserung der gesundheitlichen Versorgung dieser Bevölkerungsgruppen einzuleiten. Im Rahmen einer Zuwendung der Bundeszentrale für gesundheitliche Aufklärung (BZgA) führten wir daher eine bundesweite gemischt quantitativ-qualitative („Mixed-Methods“-)Analyse der gesundheitlichen Versorgungssituation von Asylsuchenden durch. Strukturen, Prozesse sowie prioritäre Bedarfe bei der gesundheitlichen Versorgung dieser Bevölkerungsgruppe entlang des Kontinuums von der Erstaufnahmeeinrichtung bis hin zur Folgeunterbringung in Gemeinschaftsunterkünften aus Sicht der Gesundheitsämter abzubilden. Tab. 1 Rücklauf der schriftlichen Befragung und Teilnahme an der qualitativen Befragung sowie
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