Trial reportBMC public health2020
Differences in realized access to healthcare among newly arrived refugees in Germany: results from a natural quasi-experiment.
Trial report in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed.
- The effect of health on refugees' labor market integration: Evidence from a natural experiment in Germany.PloS one · 2026Article
- Transition in care interventions for Refugee, Immigrant and other Migrant (RIM) populations: a health equity-oriented scoping review.Globalization and health · 2025Article
- [Experiences of people with refugee backgrounds in utilising healthcare in Germany-findings from a qualitative study].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2023Article
- Context, health and migration: a systematic review of natural experiments.EClinicalMedicine · 2023Article
- [Health of people with selected citizenships in Germany: prevalence of non-communicable diseases and associated social as well as migration-related factors].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2023Article
- Associations between physical and mental health and the utilization of ambulatory and emergency healthcare among asylum-seekers: results from a cross-sectional survey in Berlin, Germany.International journal for equity in health · 2023Article
- Mental health of people with limited access to health services: a retrospective study of patients attending a humanitarian clinic network in Germany in 2021.BMC psychiatry · 2023Article
- Health of people with selected citizenships: results of the study GEDA Fokus.Journal of health monitoring · 2023Article
- How schools in Germany shape and impact the lives of adolescent refugees in terms of mental health and social mobility.SSM - population health · 2022Article
- "We assist the health system doing the work that should be done by others" - a qualitative study on experiences of grassroots level organizations providing refugee health care during the 2015 migration event in Germany.BMC health services research · 2022Article
- Inequalities in access to healthcare by local policy model among newly arrived refugees: evidence from population-based studies in two German states.International journal for equity in health · 2022Article
- Health Care for Refugees in Europe: A Scoping Review.International journal of environmental research and public health · 2022Article
- Association between psychosocial functioning, health status and healthcare access of asylum seekers and refugee children: a population-based cross-sectional study in a German federal state.Child and adolescent psychiatry and mental health · 2021Article
- Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 2.Journal of clinical medicine · 2021Review
- Monitoring the health and healthcare provision for refugees in collective accommodation centres: Results of the population-based survey RESPOND.Journal of health monitoring · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundGermany has a statutory health insurance (SHI) that covers nearly the entire population and most of the health services provided. Newly arrived refugees whose asylum claim is still being processed are initially excluded from the SHI. Instead, their entitlements are restricted and parallel access models have been implemented. We assessed differences in realized access of healthcare services between these access models.
methodsIn Germany's largest federal state, North Rhine-Westphalia, two different access models have been implemented in the 396 municipalities: the healthcare voucher (HcV) model and the electronic health card (eHC) model. As refugees are quasi-randomly assigned to municipalities, we were able to realize a natural quasi-experiment including all newly assigned refugees from six municipalities (three for each model) in 2016 and 2017. Using claims data, we compared the standardized incidence rates (SIR) of specialist services use, emergency services use, and hospitalization due to ambulatory care sensitive conditions (ACSC) between both models. We indirectly standardized utilization patterns first for age and then for the sex.
resultsSIRs of emergency use were higher in municipalities with HcV (ranging from 1.41 to 2.63) compared to emergency rates in municipalities with eHC (ranging from 1.40 to 1.71) and differed significantly from the expected rates derived from official health reporting. SIRs of emergency and specialist use in municipalities with eHC converged with the expected rates over time. There were no significant differences in standardized hospitalization rates for ACSC.
conclusionThe results suggest that the eHC model is slightly better able to provide refugees with SHI-like access to specialist services and goes along with lower utilization of emergency services compared to the HcV model. No difference between the models was found for hospitalizations due to ACSC. Results might be slightly biased due to incompletely documented service use and due to (self-) selection on the level of municipalities with municipalities interested in facilitating access showing more interest in joining the project.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.