Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states

Wenner J, Biddle LR, Gottlieb ND, Bozorgmehr K (2022)
International Journal for Equity in Health 21(1): 11.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
Download
Es wurden keine Dateien hochgeladen. Nur Publikationsnachweis!
Abstract / Bemerkung
BACKGROUND: Access to healthcare is restricted for newly arriving asylum seekers and refugees (ASR) in many receiving countries, which may lead to inequalities in health. In Germany, regular access and full entitlement to healthcare (equivalent to statutory health insurance, SHI) is only granted after a waiting time of 18 months. During this time of restricted entitlements, local authorities implement different access models to regulate asylum seekers' access to healthcare: the electronic health card (EHC) or the healthcare voucher (HV). This paper examines inequalities in access to healthcare by comparing healthcare utilization by ASR under the terms of different local models (i.e., regular access equivalent to SHI, EHC, and HV).; METHODS: We used data from three population-based, cross-sectional surveys among newly arrived ASR (N=863) and analyzed six outcome measures: specialist and general practitioner (GP) utilization, unmet needs for specialist and GP services, emergency department use and avoidable hospitalization. Using logistic regression, we calculated odds ratios (OR) and 95% confidence intervals for all outcome measures, while considering need by adjusting for socio-demographic characteristics and health-related covariates.; RESULTS: Compared to ASR with regular access, ASR under the HV model showed lower needs-adjusted odds of specialist utilization (OR=0.41 [0.24-0.66]) while ASR under the EHC model did not differ from ASR with regular access in any of the outcomes. The comparison between EHC and HV model showed higher odds for specialist utilization under the EHC model as compared to the HV model (OR=2.39 [1.03-5.52]). GP and emergency department utilization, unmet needs and avoidable hospitalization did not show significant differences in any of the fully adjusted models.; CONCLUSION: ASR using the HV are disadvantaged in their access to healthcare compared to ASR having either an EHC or regular access. Given equal need, they use specialist services less. The identified inequalities constitute inequities in access to healthcare that could be reduced by policy change from HV to the EHC model during the initial 18 months waiting time, or by granting ASR regular healthcare access upon arrival. Potential patterns of differences in GP utilization, unmet needs, emergency department use and avoidable hospitalization between the models deserve further exploration in future studies. © 2022. The Author(s).
Erscheinungsjahr
2022
Zeitschriftentitel
International Journal for Equity in Health
Band
21
Ausgabe
1
Art.-Nr.
11
eISSN
1475-9276
Page URI
https://pub.uni-bielefeld.de/record/2960862

Zitieren

Wenner J, Biddle LR, Gottlieb ND, Bozorgmehr K. Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states. International Journal for Equity in Health . 2022;21(1): 11.
Wenner, J., Biddle, L. R., Gottlieb, N. D., & Bozorgmehr, K. (2022). Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states. International Journal for Equity in Health , 21(1), 11. https://doi.org/10.1186/s12939-021-01607-y
Wenner, J., Biddle, L. R., Gottlieb, N. D., and Bozorgmehr, K. (2022). Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states. International Journal for Equity in Health 21:11.
Wenner, J., et al., 2022. Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states. International Journal for Equity in Health , 21(1): 11.
J. Wenner, et al., “Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states”, International Journal for Equity in Health , vol. 21, 2022, : 11.
Wenner, J., Biddle, L.R., Gottlieb, N.D., Bozorgmehr, K.: Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states. International Journal for Equity in Health . 21, : 11 (2022).
Wenner, Judith, Biddle, Louise Rosa, Gottlieb, Nora Dalia, and Bozorgmehr, Kayvan. “Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states”. International Journal for Equity in Health 21.1 (2022): 11.
Link(s) zu Volltext(en)
Access Level
OA Open Access

Export

Markieren/ Markierung löschen
Markierte Publikationen

Open Data PUB

Web of Science

Dieser Datensatz im Web of Science®

Quellen

PMID: 35073919
PubMed | Europe PMC

Suchen in

Google Scholar