Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of
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(2020) 20:961
RESEARCH ARTICLE
Open Access
Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of claims data Andreas Niedermaier1* , Anna Freiberg1, Daniel Tiller2, Andreas Wienke1 and Amand Führer1
Abstract Background: Asylum seekers are a vulnerable group with special needs in health care due to their migration history and pre-, peri- and postmigratory social determinants of health. However, in Germany access to health care is restricted for asylum seekers by law and administrative regulations. Methods: Using claims data generated in the billing process of health care services provided to asylum seekers, we explore their utilization of health care services in the outpatient sector. We describe the utilization of outpatient specialties, prevalences of diagnoses, prescribed drugs and other health care services, as well as total costs of health care provision. Results: The estimated prevalence for visiting an ambulatory physician at least once per year was 67.5% [95%Confidence-Interval (CI): 65.1–69.9%], with a notably higher prevalence for women than men. The diagnoses with the highest one-year prevalence were “Acute upper respiratory infections” (16.1% [14.5–18.0%]), “Abdominal and pelvic pain” (15.6% [13.9–17.4%]) and “Dorsalgia” (13.8% [12.2–15.5%]). A total of 21% of all prescriptions were for common pain killers. Women received more diagnoses across most diagnosis groups and prescribed drugs from all types than men. Less than half (45.3%) of all health care costs were generated in the outpatient sector. Conclusion: The analysis of claims data held in a municipal social services office is a novel approach to gain better insight into asylum seekers’ utilization of health services on an individual level. Compared to regularly insured patients, four characteristics in health care utilization by asylum seekers were identified: low utilization of ambulatory physicians; a gender gap in almost all services, with higher utilization by women; frequent prescription of pain killers; and a low proportion of overall health care costs generated in the outpatient sector. Further research is needed to describe structural and individual factors producing these anomalies. Keywords: Secondary data analysis, Claims data, Asylum seekers, Health care utilization, Health care expenditures, Restricted access
* Correspondence: [email protected] 1 Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indic
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