Future Challenges for the Public and Curative Health Sector

Butenop, Joost; Pruskil, Susanne; Grünberger, Eva

doi:10.1007/978-3-030-03155-8_10

Cited by 8 publications

(7 citation statements)

References 13 publications

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“…We were also surprised by the relatively low take-up rates. While interpreting costs were covered by the refugee first reception centres [ 38 ], the vague assessment of these costs presented a major obstacle to adequate healthcare provision outside these centres [ 27 ]. We had expected that offering a free, professional solution to the undeniable problem of a language barrier would lead to a high general interest in participating in this kind of study.…”

Section: Discussionmentioning

confidence: 99%

“…Many of these patients receive regular healthcare services now, despite the language barrier still applying to the majority of this group. The lack of professional interpreting in primary care settings therefore continues to be the main challenge for an adequate provision of healthcare services to this group of patients [ 27 ]. However, there are no large-scale studies comparing TR and VR with one another and with control groups in primary care settings in the German-speaking areas.…”

Section: Introductionmentioning

confidence: 99%

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Remote interpreting in primary care settings: a feasibility trial in Germany

Fiedler

Pruskil

Wiessner

et al. 2022

BMC Health Serv Res

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Background Global migration trends have led to a more diverse population in health care services everywhere, which in turn has set off a paradigm shift away from medical paternalism toward more patient autonomy. Consequently, physicians need to provide a more precise patient-centred healthcare. Professional interpreting appears to play a crucial part in tackling the challenges of language barriers adequately. The aim of this study was to conduct process evaluation through the implementing of video remote interpreting (VR) and telephone remote interpreting (TR) within primary care facilities in the northern German metropolis of Hamburg. Methods We conducted a three-armed exploratory pilot trial, which compared VR to TR and to a control group (CG) in different primary care settings. We assessed feasibility of implementation, as well as the acceptance of interpreting tools among their users. In addition, we compared the quality of communication as perceived by patients and physicians, as well as the enabling of patient-centred medicine over all three study groups using quantitative questionnaires. Results 13 practices (7 GPs, 3 Gynaecologists, 3 Paediatricians) took part in this trial. 183 interpreting calls were documented, 178 physicians as well as 127 patients answered their respective questionnaires. The implementation of the VR- und TR-tools went smoothly and they were broadly accepted by their users. However, the tools were used significantly less often than we had anticipated. With regards to quantitative questionnaires, VR scored significantly better than the control group in terms of the perceived quality of communication by both, patients and physicians and enabled of patient-centred medicine. Conclusion Our main findings were the discrepancy between the assumed high demand of professional interpreting solutions on the one hand and the low willingness of practices to participate on the other. The rather low utilisation rates were also noteworthy. This discrepancy indicates a lack of awareness concerning the adverse effects of using informal or no interpreter in medical settings, which needs to be rectified. Due to the small sample size, all statistical results must be viewed with caution. However, our results show that remote interpreting represents a promising approach to tackling language barriers in primary care settings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Remote interpreting in primary care settings: a feasibility trial in Germany

Fiedler

Pruskil

Wiessner

et al. 2022

BMC Health Serv Res

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“…Legal limitations of access to healthcare can provoke a conflict between medical professional ethics and legal regulations [ 68 ]. Undocumented migrants are in a particularly difficult position.…”

Section: Discussionmentioning

confidence: 99%

Equal access to healthcare in national legislations: how do Croatia, Germany, Poland, and Slovenia counteract discrimination in healthcare?

Bielińska

Chowaniec

Doričić

et al. 2022

BMC Health Serv Res

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Background The aim of the study was a comparative analysis of legislative measures against discrimination in healthcare on the grounds of a) race and ethnicity, b) religion and belief, and c) gender identity and sexual orientation in Croatia, Germany, Poland and Slovenia. Methods We conducted a search for documents in national legal databases and reviewed legal commentaries, scientific literature and official reports of equality bodies. We integrated a comparative method with text analysis and the critical interpretive approach. The documents were examined in their original languages: Croatian, German, Polish, and Slovenian. Results All examined states prohibit discrimination and guarantee the right to healthcare on the constitutional level. However, there are significant differences among them on the statutory level, regarding both anti-discriminatory legal measures and other legislation affecting access to healthcare for groups of diverse race or ethnicity, religion or belief, sexual orientation or gender identity. Croatia and Slovenia show the most comprehensive legislation concerning non-discrimination in healthcare in comparison to Germany and even more Poland. Except for Slovenia, explicit provisions protecting equal access for members of the abovementioned groups are insufficiently represented in healthcare legislation. Conclusions The study identified legislative barriers to access to healthcare for persons of diverse race or ethnicity, religion or belief, sexual orientation or gender identity in Croatia, Germany, Poland and Slovenia. The discrepancies in the level of implementation of anti-discriminatory measures among these states show that there is a need for comprehensive EU-wide regulations, which would implement the principle of equal treatment in the specific context of healthcare. General anti-discrimination regulations should be strengthened by inclusion of anti-discrimination provisions directly into national legislation relating specifically to the area of healthcare.

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“…Der Föderalismus wird zu vielfältigen Umsetzungsvarianten führen, die später entsprechend einem „natürlichen Experiment“ evaluiert werden sollten. Bereits jetzt zeigen der Krieg in der Ukraine und die damit einhergehende Fluchtmigration erneut, wie unabdingbar es ist, die Rolle und Handlungsfähigkeit des ÖGD nachhaltig zu stärken 44 45 .…”

Section: Diskussionunclassified

Gesundheitliche Lage in der Ukraine vor Kriegsbeginn und ihre Relevanz für die Versorgung ukrainischer Geflüchteter in Deutschland: Literaturdurchsicht, Risikoanalyse und Prioritätensetzung

Butenop¹,

Brake

Mauder

et al. 2022

Gesundheitswesen

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Zusammenfassung Hintergrund Die gesundheitlichen Bedarfe Geflüchteter ergeben sich nicht nur aus Expositionen während Krieg und Flucht. Auch Determinanten aus dem Lebenslauf und etabliertes Gesundheitsverhalten spielen eine Rolle. Wir untersuchten daher die gesundheitliche Lage in der Ukraine vor der russischen Invasion 2022 und ihre Relevanz für die Versorgung ukrainischer Geflüchteter in Deutschland aus Sicht des Öffentlichen Gesundheitsdienstes (ÖGD). Methode Rapid Review in der Medline-Datenbank sowie Suche in einschlägigen ukrainischen und internationalen Gesundheitsdatenbanken. Narrative Synthese der Ergebnisse, gefolgt von einer Priorisierung der Gesundheitsprobleme und Maßnahmen durch zwei Mediziner mithilfe des Risikomatrix-Ansatzes. Ergebnisse Niedrige Impfquoten bestehen bei Covid-19 und führen zu Ausbrüchen in Unterkünften. Bei Masern und anderen Grundimmunisierungen bestehen Impflücken überwiegend bei älteren Kindern; 2–5-Jährige haben die zweite Masernimpfung noch nicht erhalten. HIV- und Tuberkulose-Therapien können durch die Flucht unterbrochen sein. Kommen zunehmend ältere Geflüchtete, so stehen aufgrund der Flucht unzureichend behandelte Herz-Kreislauferkrankungen und vorbestehende psychische Traumatisierung sowie ggf. akut therapiebedürftige Krebserkrankungen im Vordergrund. Bei ukrainischen Geflüchteten kann ein Misstrauen gegenüber mit dem Staat assoziierten Gesundheitsmaßnahmen bestehen, wie die Impflücken zeigen. Schlussfolgerung Der Zugang Geflüchteter zu kurativer und präventiver Gesundheitsversorgung sollte ohne bürokratische Hürden und Einschränkungen gewährleistet werden. Durch die Analyse von Gesundheitsstatistiken der Ukraine sowie wissenschaftlicher Publikationen können Angebote des ÖGD besser angepasst und ein Fehleinsatz von Ressourcen vermieden werden.

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Future Challenges for the Public and Curative Health Sector

Cited by 8 publications

References 13 publications

Remote interpreting in primary care settings: a feasibility trial in Germany

Remote interpreting in primary care settings: a feasibility trial in Germany

Equal access to healthcare in national legislations: how do Croatia, Germany, Poland, and Slovenia counteract discrimination in healthcare?

Gesundheitliche Lage in der Ukraine vor Kriegsbeginn und ihre Relevanz für die Versorgung ukrainischer Geflüchteter in Deutschland: Literaturdurchsicht, Risikoanalyse und Prioritätensetzung

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