Preprint Article Version 1 This version is not peer-reviewed

Influence of the Introduction of the Electronic Health Insurance Card on the Use of Medical Services by Asylum Seekers in Germany

Version 1 : Received: 18 March 2018 / Approved: 22 March 2018 / Online: 22 March 2018 (03:38:12 CET)

A peer-reviewed article of this Preprint also exists.

Claassen, K.; Jäger, P. Impact of the Introduction of the Electronic Health Insurance Card on the Use of Medical Services by Asylum Seekers in Germany. Int. J. Environ. Res. Public Health 2018, 15, 856. Claassen, K.; Jäger, P. Impact of the Introduction of the Electronic Health Insurance Card on the Use of Medical Services by Asylum Seekers in Germany. Int. J. Environ. Res. Public Health 2018, 15, 856.

Journal reference: Int. J. Environ. Res. Public Health 2018, 15, 856
DOI: 10.3390/ijerph15050856

Abstract

Objectives Asylum seekers in Germany represent a highly vulnerable group from a health perspective due to a variety of risk factors. At the same time their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons, there is hardly any empirical evidence on its actual impact on the use of medical services Study design Thus, the aim of this study is to examine the influence of the possession of the EHIC on the use of medical services by asylum seekers as measured by their consultation rate of ambulant physicians (CR). For this purpose, a standardized survey was carried out to 260 asylum seekers in different municipalities of which some have introduced the EHIC for asylum seekers, while others have not. Methods Various CR were differentiated considering possible third variables as well as confounding factors. The period prevalence was compared between the groups "with EHIC" and "without EHIC" using a two-sided t-test. Multivariate analysis was done using a linear OLS regression model. Results Asylum seekers who are in possession of the EHIC are significantly more likely to seek ambulant medical care than those receiving healthcare-vouchers. Their CR, however, does not differ significantly from the age-corrected CR of the autochtonous population. Taking into account relevant covariables, the possession of the EHIC can be viewed as an independent influencing factor on the asylum seekers' use of medical care. Conclusions The results of this study suggest that having to ask for healthcare-vouchers at the social security office could be a relevant barrier for asylum seekers. Nevertheless, the ownership of the EHIC does not seem to lead to an overuse of medical services.

Subject Areas

public health; asylum seeker; electronic health insurance card; refugee; Germany

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