Abstract
Objectives: Asylum seekers in Germany represent a highly vulnerable group from a health perspective. Furthermore, their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons, there is hardly any empirical evidence regarding its actual impact on the use of medical services. The aim of the study is to examine this impact on the use of medical services by asylum seekers as measured by their consultation rate of ambulant physicians (CR). Study Design: For this purpose, a standardized survey was conducted with 260 asylum seekers in different municipalities, some of which have introduced the EHIC for asylum seekers, while others have not. Methods: The period prevalence was compared between the groups “with EHIC” and “without EHIC” using a two-sided t-test. Multivariate analysis was done using a linear OLS regression model. Results: Asylum seekers in possession of the EHIC are significantly more likely to seek ambulant medical care than those receiving healthcare-vouchers. Conclusions: The results of this study suggest that having to ask for healthcare-vouchers at the social security office could be a relevant barrier for asylum seekers.
Highlights
Worldwide there are 65.3 million people fleeing from war, violence and persecution [1]
The results of this study suggest that having to ask for healthcare-vouchers at the social security office could be a relevant barrier for asylum seekers
93 asylum seekers had been able to collect experiences with healthcare-vouchers as well as with the Electronic Health Insurance Card (EHIC), because during their stay they first had been treated with healthcare-vouchers and after some time they received the EHIC
Summary
Worldwide there are 65.3 million people fleeing from war, violence and persecution [1]. In 2015 and 2016, a total of 1,222,194 refugees submitted a request for asylum in Germany. Federal Office for Migration and Refugees made 978,459 decisions about applications. The average operation time was 5.4 months [2,3]. A total of 21.21% of the asylum seekers were allocated to North. Rhine-Westphalia in 2016 [4]. There is a complex relationship between flight and health, wherein there are many mutually influential factors [5]. While morbidity and mortality of migrants, which are similar to those of the majority population, are discussed as “healthy migrant effects”, there are some peculiarities among asylum seekers [6]. There are increased rates of infectious diseases such as tuberculosis, HIV or hepatitis, scabies or measles [7,8,9]
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