Health Care Services Utilization and Health-Related Quality of Life of Syrian Refugees with Post-Traumatic Stress Symptoms in Germany (the Sanadak Trial)

Abstract

Refugees who have fled from the ongoing civil war in Syria that arrived in Germany often develop post-traumatic stress symptoms (PTSS). The aim of this study was to determine health care services utilization (HCSU), health care costs and health-related quality of life (HrQoL) of Syrian refugees with mild to moderate PTSS without current treatment in Germany. The study was based on the baseline sample of a randomized controlled trial of a self-help app for Syrian refugees with PTSS (n = 133). HCSU and HrQoL based on the EQ-5D-5L and its visual analogue scale (EQ-VAS) were assessed with standardized interviews. Annual health care costs were calculated using extrapolated four-month HCSU and standardized unit costs. Associations between health care costs, HrQoL and PTSS severity were examined using generalized linear models. Overall, 85.0% of the sample utilized health care services within four months. The mean total annual health care costs were EUR 1920 per person. PTSS severity was not associated with health care costs. The EQ-5D-5L index score and the EQ-VAS score was 0.82 and 73.6, respectively. For Syrian refugees with higher PTSS severity, the EQ-5D-5L index score was lower (−0.17; p < 0.001). The HCSU and the resulting health care costs of Syrian refugees with mild to moderate PTSS without current treatment are low and those with a higher PTSS severity had a lower HrQoL.

Post-Migration Stressors and Health-Related Quality of Life in Refugees from Syria Resettled in Sweden

“…Approximately half of the refugees were under 40 years of age compared to 9% in the Swedish sample, and there exists a known and very strong negative association between age and HRQoL. The estimated mean index score is also somewhat higher than the 0.82 value found in a study of Syrian refugees resettled in Germany [ 18 ]. Possible explanations for this difference include the use of value sets obtained from different populations (Sweden versus Germany).…”

“…Few studies in the published literature to date have explored HRQoL in refugee populations using such a preference-based approach. One study of 133 Syrian refugees in Germany found that the HRQoL of the refugees reported was lower compared to a representative German population sample [ 18 ]. A prior publication by our research group used the EQ–5D–5L index score to examine gender differences in HRQoL in Syrian adult refugees resettled in Sweden but based on the United Kingdom population data as no value set was available for the Swedish population at the time [ 19 ].…”

Shared sorrow, shared costs: cost-effectiveness analysis of the Empowerment group therapy approach to treat affective disorders in refugee populations

“…They were also equal to the annual resource use costs for Syrian refugees of €1920 reported by a RCT using a bottomup approach. 37 The main cost driver in all studies was in-patient healthcare, owing to inadequate provision of or access to primary and preventive care. 14 In addition, Empowerment proved to be effective in reducing depressive symptoms in RAS.…”

The Effect of Educational Program on Pain Management, Self-Efficacy Behavior, and Quality of Life among Adult Diabetic Patients with Peripheral Neuropathy Pain: A Randomized Controlled Trial

“…This scale has been shown to be reliable with α=0.88 8 . Domains of the EQ-5D include anxiety/depression, usual activities (e. g., housework, study, work, leisure, or family activities), mobility, self-care, and pain/discomfort 23 .…”

“…3) The QoL was evaluated using the quality-of-life questionnaire entitled EQ-5D [23]. The EQ5D (five-level version) contained five items with each having five response options: 1 (no problems), 2 (slight problems), 3 (moderate problems), 4 (severe problems), and 5 (extreme problems).…”