Challenges in health care services for refugees in Cologne, Germany: A providers' perspective using a mixed-methods approach.

Journal: Journal of migration and health

Volume: 7

Issue: 

Year of Publication: 

Affiliated Institutions:  LMU Klinikum, Marchioninistr. , , Munich, Germany. Heidelberg Institute of Global Health (HIGH), Im Neuenheimer Feld ., , University Heidelberg, Heidelberg, Germany. Public Health Department of the City of Cologne, Neumarkt -, , Cologne, Germany.

Abstract summary 

Since the peak of refugees arriving in Germany in 2015, existing health care structures have faced major challenges. The city of Cologne developed ad-hoc new structures to address these challenges, including a separate department for refugee medicine. We examine the processes of health care provision and perceived challenges in the health care of refugees in Cologne. We used a mixed-methods approach using 20 semi-structured interviews and analyzed descriptively a database including 353 datasets with socio-demographic, health-related and resource-related information to link with the results of qualitative data. Our qualitative data revealed several challenges in providing health care to refugees. Challenges included receiving approval of health care services and medical aids by the municipality, communication and cooperation between the actors in care of refugees, undersupplies in mental health care and addictive disorders as well as improper housing conditions for refugees with mental health issues, psychiatric disorders or elderly persons. Quantitative data confirmed the challenges in approving health care services and medical aids, but no valid statement could be made about communication and cooperation. Undersupplies for mental health issues were confirmed, the gap for treatment of addictive disorders shows a divergence within the database. Improper housing conditions for mentally ill persons were reflected, for elderly persons this did not appear in data. In conclusion, analyzing the challenges in care can stimulate necessary changes to improve health services for refugees locally, while others are beyond the control of the local authority and require legislative and political action.

Authors & Co-authors:  Warmbein Angelika A Beiersmann Claudia C Eulgem Andrea A Demir Jaqueline J Neuhann Florian F

Study Outcome 

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Statistics
Citations :  Asfaw B.B., Beiersmann C., Keck V., Nikendei C., Benson-Martin J., Schütt I., Lohmann J. Experiences of psychotherapists working with refugees in Germany: a qualitative study. BMC Psychiatry. 2020;20:588. doi: 10.1186/s12888-020-02996-0.
Authors :  5
Identifiers
Doi : 100158
SSN : 2666-6235
Study Population
Male,Female
Mesh Terms
Other Terms
Accessibility;Asylum seekers;Chronic care;Germany;Health care services;Migration
Study Design
Study Approach
Quantitative,Qualitative,Mixed-Methods
Country of Study
Publication Country
England