Healthcare Utilization in a Large Cohort of Asylum Seekers Entering Western Europe in 2015

Abstract

During the current period of immigration to Western Europe, national healthcare systems are confronted with high numbers of asylum seekers with largely unknown health status. To improve care taking strategies, we assessed healthcare utilization in a large, representative cohort of newly arriving migrants consisting of n = 1533 residents of a reception center in Northern Germany in 2015. Most asylum seekers were young, male adults, and the majority came from the Eastern Mediterranean region. Overall, we observed a frequency of 0.03 visits to the onsite primary healthcare ward per asylum seeker and day of camp residence (IQR 0.0–0.07, median duration of residence 38.0 days, IQR 30.0–54.25). Female asylum seekers showed higher healthcare utilization rates than their male counterparts, and healthcare utilization was particularly low in asylum seekers in their second decade of life. Furthermore, a significant correlation between time after camp entrance and healthcare utilization behavior occurred: During the first week of camp residence, 37.1 visits/100 asylum seekers were observed, opposed to only 9.5 visits/100 asylum seekers during the sixth week of camp residence. This first data on healthcare utilization in a large, representative asylum seeker cohort entering Western Europe during the current crisis shows that primary care is most needed in the first period directly after arrival. Our dataset may help to raise awareness for refugee and migrant healthcare needs and to adapt care taking strategies accordingly.

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

“…This can only in part be explained through pregnancies and birth, as it holds true for almost all diagnosis groups and rates of health care services. These findings replicate other reports [21,67,68]. This might point towards lower access barriers for migrant women or higher health care needs, but we found no published research regarding this topic.…”

Health care needs among recently arrived refugees in Germany: a cross-sectional, epidemiological study

“…In general, available evidence on refugees’ health care needs is primarily focused on needs related to mental health problems (Giacco et al 2018 ; Nesterko et al 2020 ), as well as chronic (Goosen 2014 ) and infectious diseases (Yun et al 2012 ). However, despite numerous reports indicating higher symptom burden, and in consequence increased needs for health care in different refugee populations, data on refugees’ health care needs and/or utilization remains inconsistent (Wetzke et al 2018 ; Yang and Hwang 2016 ). This might be attributable to the great heterogeneity within refugee populations (e.g., due to countries of origin, flight route and duration, exposure to different traumatic events before, during, and/or after the flight) on the one hand, and differences in health policies towards asylum-seekers in different host countries on the other.…”

“…In addition to the legal and bureaucratic barriers described above, there are factors on the individual level such as age and sex that influence health care needs and utilization in different refugee populations. In Germany, Wetzke et al ( 2018 ) found higher healthcare utilization in refugee children age 10 and under as well as in refugees age 60 and older. Moreover, reports fairly consistently indicate that female refugees utilize health care more often than males do (Bozorgmehr et al 2015 ; Gerritsen et al 2006 ; Henjum et al 2012 ).…”

Health of Refugees and Migrants—Where Do We Stand and What Directions Should We Take?

“…This issue also documents how migrants and refugees access health services and some of their health care outcomes [26,27,28,29,30,31,32,33,34,35]. Studies in this special issue emphasize the need for well-structured policies and guidelines in the EU to ensure the proper integration of AS and refugees within health systems.…”