2.10-P10Cost savings through timely treatment for irregular migrants and European Union citizens without insurance

Trummer, Ursula; Novak-Zezula, Sonja; Реннер, А. Г.; Wilczewska, I

doi:10.1093/eurpub/cky048.061

Cited by 13 publications

(16 citation statements)

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“…This is in line with former research, showing high prevalences of hospitalization [ 67 , 76 ] and high costs of inpatient health-care [ 54 , 65 ] among asylum seekers. To reverse this shift back to the cost-efficient arena of primary and preventative care, this calls for initiatives to provide timely and adequate care both in the receiving country and along the migration routes to reduce the morbidity and health care costs in the long term [ 22 , 28 ]. Further research is needed to investigate the causes and extent of preventable hospitalization among asylum seekers through restricted access to health care.…”

Section: Discussionmentioning

confidence: 99%

“…These restrictions and barriers impair the utilization of health services [ 2 , 3 , 19 ], alienate patients from the health care system [ 9 , 10 ] and increase overall costs of health care provision to this group in the long term [ 18 , 22 , 28 ]. Nevertheless, little is known about the specifics of the utilization of health care by asylum seekers and the effects of these restrictions and barriers.…”

Section: Introductionmentioning

confidence: 99%

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Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of claims data

Niedermaier

Freiberg

Tiller

et al. 2020

BMC Health Serv Res

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Background Asylum seekers are a vulnerable group with special needs in health care due to their migration history and pre-, peri- and postmigratory social determinants of health. However, in Germany access to health care is restricted for asylum seekers by law and administrative regulations. Methods Using claims data generated in the billing process of health care services provided to asylum seekers, we explore their utilization of health care services in the outpatient sector. We describe the utilization of outpatient specialties, prevalences of diagnoses, prescribed drugs and other health care services, as well as total costs of health care provision. Results The estimated prevalence for visiting an ambulatory physician at least once per year was 67.5% [95%-Confidence-Interval (CI): 65.1–69.9%], with a notably higher prevalence for women than men. The diagnoses with the highest one-year prevalence were “Acute upper respiratory infections” (16.1% [14.5–18.0%]), “Abdominal and pelvic pain” (15.6% [13.9–17.4%]) and “Dorsalgia” (13.8% [12.2–15.5%]). A total of 21% of all prescriptions were for common pain killers. Women received more diagnoses across most diagnosis groups and prescribed drugs from all types than men. Less than half (45.3%) of all health care costs were generated in the outpatient sector. Conclusion The analysis of claims data held in a municipal social services office is a novel approach to gain better insight into asylum seekers’ utilization of health services on an individual level. Compared to regularly insured patients, four characteristics in health care utilization by asylum seekers were identified: low utilization of ambulatory physicians; a gender gap in almost all services, with higher utilization by women; frequent prescription of pain killers; and a low proportion of overall health care costs generated in the outpatient sector. Further research is needed to describe structural and individual factors producing these anomalies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of claims data

Niedermaier

Freiberg

Tiller

et al. 2020

BMC Health Serv Res

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“…A growing body of evidence indicates that restrictive policies increase rather than decrease costs (see, e.g., [5,6]). Yet the public debate ignores such findings and they remain relatively overlooked even within the field.…”

Section: Introductionmentioning

confidence: 99%

Economic arguments in migrant health policymaking: proposing a research agenda

et al. 2020

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Welfare states around the world restrict access to public healthcare for some migrant groups. Formal restrictions on migrants’ healthcare access are often justified with economic arguments; for example, as a means to prevent excess costs and safeguard scarce resources. However, existing studies on the economics of migrant health policies suggest that restrictive policies increase rather than decrease costs. This evidence has largely been ignored in migration debates. Amplifying the relationship between welfare state transformations and the production of inequalities, the Covid-19 pandemic may fuel exclusionary rhetoric and politics; or it may serve as an impetus to reconsider the costs that one group’s exclusion from health can entail for all members of society.The public health community has a responsibility to promote evidence-informed health policies that are ethically and economically sound, and to counter anti-migrant and racial discrimination (whether overt or masked with economic reasoning). Toward this end, we propose a research agenda which includes 1) the generation of a comprehensive body of evidence on economic aspects of migrant health policies, 2) the clarification of the role of economic arguments in migration debates, 3) (self-)critical reflection on the ethics and politics of the production of economic evidence, 4) the introduction of evidence into migrant health policymaking processes, and 5) the endorsement of inter- and transdisciplinary approaches. With the Covid-19 pandemic and surrounding events rendering the suggested research agenda more topical than ever, we invite individuals and groups to join forces toward a (self-)critical examination of economic arguments in migration and health, and in public health generally.

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“…However, a number of homeless individuals are unable or otherwise do not want to contact authorities or comply with necessary regulations for obtaining health insurance. Additionally, there is an unknown number of undocumented migrants who are not allowed to obtain health insurance, as they do not hold a regular residence permit [15].…”

Section: Health Care Provision For the Homelessmentioning

confidence: 99%

How Structural Compensation Facilitates Health Care for the Homeless. A Comparative View on Four European Union Member States

Trummer

Novak-Zezula

Chrzanowska

et al. 2020

IJERPH

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There is robust evidence that homelessness and the associated life conditions of a homeless person may cause and exacerbate a wide range of health problems, while healthcare for the homeless is simultaneously limited in accessibility, availability, and appropriateness. This article investigates legal frameworks of health care provision, existing knowledge on numbers of homeless to be considered, and current means of health care provision for four EU countries with different economic and public health background: Austria, Greece, Poland, and Romania. National experts investigated the respective regulations and practices in place with desk research. The results show differences in national frameworks of inclusion into health care provision and knowledge on the number of people experiencing homelessness, but high similarity when it comes to main actors of actual health care provision for homeless populations. In all included countries, despite their differences in economic investments and universality of access to public health systems, it is mainly NGOs providing health care to those experiencing homelessness. This phenomenon fits into conceptual frameworks developed around service provision for vulnerable population groups, wherein it has been described as “structural compensation,” meaning that NGOs compensate a structural inappropriateness that can be observed within public health systems.

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2.10-P10Cost savings through timely treatment for irregular migrants and European Union citizens without insurance

Cited by 13 publications

References 0 publications

Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of claims data

Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of claims data

Economic arguments in migrant health policymaking: proposing a research agenda

How Structural Compensation Facilitates Health Care for the Homeless. A Comparative View on Four European Union Member States

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