PUB - Publikationen an der Universität Bielefeld

AIM OF THE STUDY: Access to healthcare for newly arrived refugees and asylum seekers is organised differently in the municipalities throughout Germany, both with regard to the organisation of support services and the choice of an access model (electronic health card/eHC or healthcare voucher/HcV). Some German states and municipalities have introduced the eHC model in the last years. Using the example of North-Rhine Westphalia (NRW), Germany's largest state, we analyse how access to healthcare is organised from the point of view of refugees and what role the healthcare model (eHC vs. HcV) plays for their access to healthcare.; METHODS: In 3 municipalities in NRW (2 with HcV and one with eHC), 31 interviews were conducted with refugees at 2 points in time (duration of stay in Germany ≤ 15 and > 15 months) in order to account for the different legal entitlements to healthcare. To include different perspectives and challenges, we ensured maximum variation of the interview partners with regard to age, gender, chronic diseases, pregnancy and parenthood. The interviews were conducted with the support of interpreters. The transcripts of the interviews were evaluated using computer-assisted content analysis (atlas.ti 8).; RESULTS: In municipalities with a HcV model, the approval process at the social welfare office leads to additional waiting time for (continued) treatment. The more direct access through the eHC model and the elimination of entitlement restrictions after 15 months of stay can facilitate access to care, especially for chronically ill refugees. Initial contact with the health system is usually facilitated by social workers, friends or family members.; CONCLUSIONS: The eHC model can facilitate access for refugees with higher healthcare needs. Further access barriers, such as the limited availability of interpreters, exist independently of the access model. Thieme. All rights reserved.