Hemmnisse abbauen, Gesundheit fördern – Die Gesundheitsversorgung von Migrierten ohne Papiere im Rahmen eines Modellprojektes in Niedersachsen, 2016–2018

Mylius, Maren; Dreesman, Johannes; Zühlke, C; Mertens, Elke

doi:10.1007/s00103-019-02972-4

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…If adequate public health was the goal for policymakers, as signed and ratified by Germany on the International Covenant on Economic, Social and Cultural Rights [ 54 , 55 , 56 ], UM must be able to access good quality health care (i.e., the regular health care system) in an efficient and universal manner. State-level projects such as the anonymous health voucher (“Anonymer Krankenschein”) [ 57 ] could be a means to overcome the structural fragmentation found in this study and provide widespread access to health care regardless of specific services in the scope of current national legal practice. Similar considerations have led to the introduction of the electronic health card (EHC) for asylum seekers [ 58 ], as in Germany, this population was only able to access limited health services on an ad hoc basis via treatment vouchers [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Health Status and Access to Healthcare for Uninsured Migrants in Germany: A Qualitative Study on the Involvement of Public Authorities in Nine Cities

Kratzsch

Bozorgmehr

Szécsényi

et al. 2022

IJERPH

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Non-governmental organisations (NGOs) regularly report data on their work with uninsured migrants (UM) within a (so-called) parallel health care system. The role and involvement of public authorities therein have yet been underrepresented in research. Our aim was to gain a better understanding of public authorities’ role in the parallel health care system and their view of the health situation of UM. We conducted qualitative semi-structured interviews with 12 experts recruited by purposive sampling from local public health authorities (LPHAs), state-level public health authorities (SPHAs), and social services offices (SSO) in nine cities, recorded, transcribed, and subjected the data to qualitative content analysis. LPHAs are more often directly involved in providing medical services, while SSOs and SPHAs function as gatekeepers for access to social benefits, including health insurance, and in grant-funded projects. NGOs keep substituting for the lack of access to regular health care from public institutions, but even in settings with extended services, public authorities and NGOs have not been able to provide sufficient care through the parallel health care system: Experts report gaps in the provision of health care with respect to the depth and height of coverage, due to the fragmentation of services and (ostensible) resource scarcity. Our study highlights the necessity for universal access to regular health care to overcome the fragmentation of services and improve access to needed health care for UM in Germany.

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Section: Discussionmentioning

confidence: 99%

Health Status and Access to Healthcare for Uninsured Migrants in Germany: A Qualitative Study on the Involvement of Public Authorities in Nine Cities

Kratzsch

Bozorgmehr

Szécsényi

et al. 2022

IJERPH

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“…Otra limitación fue la ausencia de búsqueda de fuentes de literatura gris relevantes en materia de documentación de diseño, formulación e implementación de políticas públicas e iniciativas gubernamentales y no gubernamentales, como leyes, reportes técnicos y documentos institucionales, entre otros. Finalmente, otra limitación corresponde al período de tiempo en que se realizó la búsqueda, lo que deja fuera a estudios publicados en los últimos dos años, que entregan información que permitiría complementar el análisis realizado, como iniciativas implementadas en Francia (43,44) , Italia (43,45) , Tailandia (46,47) y Estados Unidos (46) , así como también aportan información sobre iniciativas no analizadas en esta revisión, existentes en Noruega (46) , Israel (48) y Alemania (49) .…”

Section: Conclusionesunclassified

Salud de migrantes internacionales en situación irregular: una revisión narrativa de iniciativas

Larenas

Cabieses

2019

Rev Peru Med Exp Salud Publica

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La población migrante internacional en situación irregular (MISI) suele encontrarse en una condición de particular vulnerabilidad que impacta en su salud, y sumado a esto, enfrenta múltiples barreras que dificultan e incluso impiden su acceso a los servicios de salud. La presente revisión tiene por objetivo identificar y describir iniciativas que abordan el acceso a los servicios de salud en población MISI. Para ello, se realizó una revisión narrativa en PubMed, Embase, Health Systems Evidence, Cochrane, LILACS y Scielo entre julio y agosto de 2017. Se encontraron 787 artículos, de los cuales se incluyeron 26, los que dieron cuenta de 31 iniciativas. La mayoría de estas iniciativas se sitúan en América Septentrional (61%), Asia Sudoriental (10%) y Europa Septentrional (10%); se refieren mayoritariamente a servicios de nivel primario (48%) y terciario (52%), servicios de urgencia/emergencia (39%), brindan accesibilidad administrativa (65%) y financiera (45%), y responden a necesidades en la etapa de «destino» del proceso migratorio (97%). Se puede concluir que existen diversas iniciativas que abordan la problemática del acceso a los servicios de salud de la población MISI. No obstante, no se hallaron iniciativas dirigidas a la rehabilitación y salud sexual; contacto y calidad; perspectiva de género y competencia cultural en salud.

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Healthcare for individuals without health insurance in Germany – a mixed methods approach to assess the situation and current challenges

Stötzler,

Kaifie

2023

Int J Equity Health

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Background Health insurance is mandatory in Germany; nevertheless, many individuals there have no health insurance and depend on a parallel healthcare structure. Voluntary associations, such as MediNetz and healthcare vouchers (“Anonymer Krankenschein” - AKS), support uninsured citizens. This study aimed to provide insights into associations, such as MediNetz and AKS that provide healthcare for individuals without health insurance in North Rhine-Westphalia, the largest federal state in Germany. Methods A mixed methods approach was chosen. A qualitative study using interviews with experts was performed to gain their knowledge and explore the various challenges that AKS and MediNetz associations faced and the possible improvements that could be made. A quantitative survey was conducted to analyse the demographic data of the patients who required AKS or MediNetz’s assistance and the characteristics of each association through a separate questionnaire. Data was received from the association in Aachen, Bielefeld, Bonn, Düsseldorf, and Essen. Results More women than men sought medical care; most were between 25 and 49 years old. The proportion of individuals without residency status accounted for the largest share (53.6%). Common reasons for patients to make contact were acute illnesses (40.2%) and pregnancies (22.3%). Most patients were sent to gynaecologists and general practitioners. Asking the experts, it became apparent that the existing system could not reach the standard of the regular healthcare in Germany. Financial and human resources were insufficient. Therefore, prevention was limited, especially chronically ill patients or patients with a severe illness requiring hospitalisation could not be treated. AKS had advantages compared to MediNetz, as the care came closer to the expected German medical standards. Conclusions The results showed a demand for associations providing healthcare for individuals without health insurance. However, the healthcare provided by MediNetz and AKS did not reach the standard of healthcare in Germany and mainly depended on the organisations’ resources. Funded projects such as an AKS combined with clearing centres significantly improved healthcare. Until structural measures are implemented, they can be a transitional solution by spreading nationwide.

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Hemmnisse abbauen, Gesundheit fördern – Die Gesundheitsversorgung von Migrierten ohne Papiere im Rahmen eines Modellprojektes in Niedersachsen, 2016–2018

Cited by 3 publications

References 12 publications

Health Status and Access to Healthcare for Uninsured Migrants in Germany: A Qualitative Study on the Involvement of Public Authorities in Nine Cities

Health Status and Access to Healthcare for Uninsured Migrants in Germany: A Qualitative Study on the Involvement of Public Authorities in Nine Cities

Salud de migrantes internacionales en situación irregular: una revisión narrativa de iniciativas

Healthcare for individuals without health insurance in Germany – a mixed methods approach to assess the situation and current challenges

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