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Does the Electronic Health Card for Asylum Seekers Lead to an Excessive Use of the Health System? Results of a Survey in Two Municipalities of the German Ruhr Area

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  • Pia Jäger

    (Section for Social Policy and Social Economy, Faculty of Social Sciences, Ruhr-University Bochum, Universitätsstr. 150, 44801 Bochum, Germany
    Department of International Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboidomein 30, 6229 CT Maastricht, The Netherlands)

  • Kevin Claassen

    (Department of Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany)

  • Notburga Ott

    (Section for Social Policy and Social Economy, Faculty of Social Sciences, Ruhr-University Bochum, Universitätsstr. 150, 44801 Bochum, Germany)

  • Angela Brand

    (Department of International Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboidomein 30, 6229 CT Maastricht, The Netherlands)

Abstract

Background: The initial and intermediate-term access of refugees to healthcare in Germany is limited. A previous study showed that the obligation to request healthcare vouchers at the social security offices decreases the asylum seekers’ consultation rate of ambulant physicians. The introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers is considered skeptically by some municipalities and federal states, among other reasons due to the fear of an overuse of health care services by asylum seekers. The aim of this study is to further evaluate the data of the authors’ initial study with a new focus on inpatient care as well as a differentiation of the ambulant consultation rate into general practitioners and outpatient specialists. Methods: The now-differentiated consultation rate of the initial study as well as the asylum seekers’ use of inpatient care are compared to the values of the sex- and age-corrected autochthonous population as given by the German Health Interview and Examination Survey for Adults (DEGS1). A mean difference test (student’s t-test) is used for comparison and significance testing. Results: Asylum seekers who were in possession of the EHIC were significantly less likely to visit their ambulant general practitioners and specialists than the German autochthonous population. Simultaneously, this difference is partly compensated for by their more frequent use of impatient care. Conclusions: There is no indication that the EHIC leads to an overuse of healthcare services.

Suggested Citation

  • Pia Jäger & Kevin Claassen & Notburga Ott & Angela Brand, 2019. "Does the Electronic Health Card for Asylum Seekers Lead to an Excessive Use of the Health System? Results of a Survey in Two Municipalities of the German Ruhr Area," IJERPH, MDPI, vol. 16(7), pages 1-9, April.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:7:p:1178-:d:219151
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    References listed on IDEAS

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    1. Alessandro Sola, 2018. "The 2015 Refugee Crisis in Germany: Concerns about Immigration and Populism," SOEPpapers on Multidisciplinary Panel Data Research 966, DIW Berlin, The German Socio-Economic Panel (SOEP).
    2. Kevin Claassen & Pia Jäger, 2018. "Impact of the Introduction of the Electronic Health Insurance Card on the Use of Medical Services by Asylum Seekers in Germany," IJERPH, MDPI, vol. 15(5), pages 1-11, April.
    3. Kayvan Bozorgmehr & Oliver Razum, 2015. "Effect of Restricting Access to Health Care on Health Expenditures among Asylum-Seekers and Refugees: A Quasi-Experimental Study in Germany, 1994–2013," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-22, July.
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    Cited by:

    1. Saleh Aljadeeah & Veronika J. Wirtz & Eckhard Nagel, 2021. "Barriers to Accessing Medicines among Syrian Asylum Seekers and Refugees in a German Federal State," IJERPH, MDPI, vol. 18(2), pages 1-16, January.
    2. Nora Gottlieb & Conny Püschmann & Fabian Stenzinger & Julia Koelber & Laurette Rasch & Martha Koppelow & Razan Al Munjid, 2020. "Health and Healthcare Utilization among Asylum-Seekers from Berlin’s LGBTIQ Shelter: Preliminary Results of a Survey," IJERPH, MDPI, vol. 17(12), pages 1-15, June.
    3. Anna Christina Nowak & Yudit Namer & Claudia Hornberg, 2022. "Health Care for Refugees in Europe: A Scoping Review," IJERPH, MDPI, vol. 19(3), pages 1-10, January.

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