(Non-)utilization of pre-hospital emergency care by migrants and non-migrants in Germany

Kietzmann, Diana; Knuth, Daniela; Schmidt, Silke

doi:10.1007/s00038-016-0904-y

Cited by 12 publications

(12 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The small number of studies ( n = 3) that examined emergency care utilization do not enable a definitive conclusion. One current publication showed higher utilization [ 40 ] among PMB while two others found no differences [ 26 , 41 ]. Also, the four studies regarding the utilization of rehabilitation (out- and inpatient) provide insufficient evidence [ 26 , 42 – 44 ], albeit the trend suggests a lower participation among PMB.…”

Section: Resultsmentioning

confidence: 99%

“… Inpatient care 10 [ 17 , 18 , 23 , 25 , 26 , 29 , 30 , 37 – 39 ] O ▪ Inconsistent results, differences in terms of type of disease. Emergency care 3 [ 26 , 40 , 41 ] O ▪ Inconsistent results: Higher probability of utilization among migrant adults, but no difference among children and adolescents. Rehabilitation 4 [ 26 , 42 – 44 ] – ▪ Results tend to lower usage among migrants.…”

Section: Resultsmentioning

confidence: 99%

“…The different ways migrants perceive health problems or face administrative requirements has to be of interest, too [ 2 ]. For the utilization of prevention or emergency care, tailored education measures on the general functioning of the German health systems should be provided for an improved patient empowerment [ 40 , 98 ]. For instance, this could be included in integration classes that are offered to people migrating to Germany.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Inequalities in health care utilization among migrants and non-migrants in Germany: a systematic review

Klein

Knesebeck

2018

Int J Equity Health

122

102

View full text Add to dashboard Cite

BackgroundDespite the growing number of people with migrant background in Germany, a systematic review about their utilization of health care and differences to the non-migrant population is lacking. By covering various sectors of health care and migrant populations, the review aimed at giving a general overview and identifying special areas of potential intervention.MethodsA systematic review was conducted in PubMed database including records that were published until 1st of June 2017. Further criteria for eligibility were a publication in a peer-reviewed journal written in English or German language. The studies have to report quantitative and original data of a population residing in Germany. The appropriateness of the studies was judged by both authors. Studies were excluded if native controls were not originated from the same sample. Moreover, indicators of health care utilization have to assess individual behaviour like consultation or participation rates. 63 studies met the inclusion criteria for a qualitative synthesis of the findings.ResultsThe overall findings indicate a lower utilization among migrants, although the results vary in terms of health care sector, indicator of health care utilization and migrant population. For specialist care, medication use, therapist consultations and counselling, rehabilitation as well as disease prevention (early cancer detection, prevention programs for children and oral health check-ups) a lower utilization among people with migrant background was found. The lower usage was particularly shown for migrants of the 1st generation, people with two-sided migrant background, children/adolescents and women. Due to the methodological heterogeneity a meta-analysis was not feasible. As most of the studies were cross-sectional, no causal interpretations could be drawn.ConclusionsThe inequalities in utilization could not substantially be explained by differences in the socioeconomic status. Other reasons of lower utilization could be due to differences in need, preferences, information, language and formal access barriers (e.g. charges, waiting times, travel distances or lost wages). Different migrant-specific and migrant-sensitive strategies are relevant to address the problem for certain health care sectors and migrant populations.Trial registrationThe review protocol was registered on PROSPERO (CRD42014015162).Electronic supplementary materialThe online version of this article (10.1186/s12939-018-0876-z) contains supplementary material, which is available to authorized users.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Inequalities in health care utilization among migrants and non-migrants in Germany: a systematic review

Klein

Knesebeck

2018

Int J Equity Health

122

102

View full text Add to dashboard Cite

show abstract

“…Against the background of the current organisation of urgent and emergency care services in Germany, the present study introduces the individual predisposing factors sex, age, education, migration background and having children into the analyses of utilisation. Predisposing factors as lower education and a migration background are often associated with more frequent or inadequate prehospital and hospital emergency care utilisation in Germany and further European countries,7 23–26 although some current findings for Germany did not confirm these inequalities 27–29. Moreover, higher age predicts increased ED use while sex does not seem to play a significant role 7 24 27 28.…”

Section: Introductionmentioning

confidence: 68%

Intended healthcare utilisation in cases of severe COVID-19 and inflammatory gastrointestinal disease: results of a population survey with vignettes

et al. 2022

View full text Add to dashboard Cite

ObjectivesTo examine variations in intended healthcare utilisation in severe cases of COVID-19 and inflammatory gastrointestinal disease (IGD).DesignRepresentative cross-sectional telephone survey.Setting and participants1207 randomly drawn adults of the city of Hamburg, Germany, between November 2020 and January 2021.Outcome measuresDifferent vignettes with severe symptoms were presented varying in sex, age (child, middle-aged person, older person), daytime (Tuesday morning or Tuesday evening) and disease (COVID-19 or IGD), while the degree of urgency was equivalent for all cases. The respondents were asked for the intended healthcare utilisation resulting in three different alternatives: general practitioner (GP)/paediatrician, medical on-call service (‘116117’) and emergency care (accident and emergency department, emergency practice, rescue service). In multivariate analyses, associations of characteristics of the vignettes and participants (sex, age, education, migration background) with intended healthcare utilisation were tested. In a further step, analyses were conducted separately for IGD and COVID-19.ResultsRegarding the vignettes’ characteristics, intended utilisation of GP/paediatrician is associated with female sex, higher age, daytime (morning) and COVID-19 symptoms, the medical on-call service with male sex, daytime (evening) and COVID-19 symptoms and the emergency medicine with younger age, daytime (evening) and IGD. Women chose more often the GP/paediatrician, men preferred emergency medicine. Only in case of IGD, higher educated persons more often chose the medical on-call service while people with a migration background decided less often for medical on-call service and emergency medicine.ConclusionsDespite comparable urgency, the findings suggest variations of intended healthcare utilisation depending on various characteristics of the vignettes and respondents. Depending on the type of disease inequalities vary. Overall, information about healthcare alternatives in severe cases has to be improved and clear pathways to facilitate healthcare utilisation has to be further developed.

show abstract

“… 53 In addition, children in seventh and eighth grade were more likely to have cold or diarrhoea instead of some serious illnesses, which may often be managed through self-medication. 54–56 However, parents in the low-acculturation group were more likely to have limited knowledge to implement successful self-medication, thereby choosing to use outpatient service after their children got ill. 57 Although parents in the low-acculturation group and poor economic status had a higher rate of outpatient service utilisation, the health facilities they chose were more likely to be society-run clinics (26.8%, the so-called private clinics), which generally have poorer service quality and lower medical expenditure without a licence, 58 instead of governmental health facilities, compared with other groups. This proportion was even higher than that among the IM workers in one study, which found that 20% IM workers selected the society-run clinic to see a doctor.…”

Section: Discussionmentioning

confidence: 99%

Association between health service utilisation of internal migrant children and parents’ acculturation in Guangdong, China: a cross-sectional study

Peng¹,

Zou²,

Chen³

et al. 2018

BMJ Open

View full text Add to dashboard Cite

ObjectivesTo assess the health service utilisation of internal migrant children in Guangdong, China, and to explore the association between children’s health service utilisation and their parents’ acculturation.DesignCross-sectional survey between April and May 2016.SettingSix society-run schools of Tianhe and Baiyun districts in Guangzhou City of China.ParticipantsWe recruited all students at grade 7 or 8 and one of their parents who resided in Guangzhou over 6 months without permanent registered residence (hukou) in Guangzhou (1161 pairs completed this survey). 258 children were ill within the past 2 weeks or during the last year.Main outcome measuresThe main outcome was self-reported health service utilisation. Logistic regression analysis was conducted to explore the association between children’s unmet needs for outpatient or inpatient service and their parents’ acculturation (categorised into high, middle and low groups).ResultsIn total, 216 children, or 18.6% of the total subjects, were ill within the past 2 weeks and were in need of outpatient service; 94 children, or 8.1% of the total subjects, were in need of inpatient service. Among them, 17.6% and 46.8% of the migrant children had unmet needs for outpatient and inpatient services, respectively. After controlling for enabling resources and predisposing characteristics, migrant children with parents in the middle-acculturation group (adjusted OR=3.17, 95% CIs 1.2 to 8.3, P<0.05) were more likely to have an unmet outpatient need than high-acculturation or low-acculturation groups, although only statistically significant when comparing with the high-acculturation group. Stratified analysis suggested that this association could be moderated by their family economic status.ConclusionsOur study suggested that the association between migrant children’s health service utilisation and their parents’ acculturation was complex and could be moderated by family economic status. Increasing the service utilisation among migrant children requires improving the acculturation and economic status of the parents of internal migrants.

show abstract

(Non-)utilization of pre-hospital emergency care by migrants and non-migrants in Germany

Abstract: To prevent over-, under-, and lack of supply, it is necessary to transfer knowledge about the functioning of the medical emergency services, including first aid knowledge.

Cited by 12 publications

References 22 publications

Inequalities in health care utilization among migrants and non-migrants in Germany: a systematic review

Inequalities in health care utilization among migrants and non-migrants in Germany: a systematic review

Intended healthcare utilisation in cases of severe COVID-19 and inflammatory gastrointestinal disease: results of a population survey with vignettes

Association between health service utilisation of internal migrant children and parents’ acculturation in Guangdong, China: a cross-sectional study

Contact Info

Product

Resources

About