Bozorgmehr Kayvan, Nöst Stefan, Thaiss Heidrun M, Razum Oliver
Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland.
Bundeszentrale für gesundheitliche Aufklärung, Köln, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016 May;59(5):545-55. doi: 10.1007/s00103-016-2329-4.
Nation-wide studies on the health care situation of asylum-seekers in Germany are lacking, but decision-makers increasingly need such information.
The aim of the study was to assess structures, processes and needs related to the health care provision for asylum-seekers along the continuum of reception centres to community dwellings from the perspective of the German public health authorities.
A nation-wide cross-sectional mixed-methods survey was carried out. All heads of public health authorities in Germany (N = 389) were invited to complete a standardized questionnaire related to: (1) medical procedures and screening; (2) prevention and health promotion; (3) communication; (4) documentation and information; (5) coordination; (6) structural resources and needs. The quantitative survey was complemented by qualitative semi-structured interviews.
In total, 123 heads of public health authorities (response rate: 31,6 %) completed the questionnaire, and 29 were interviewed. Priority areas to improve the health care situation were better coordination and standardisation of care, enhancing vaccination capacities, standardised documentation, better health information exchange (in line with data protection laws), and a stronger focus on a few relevant infectious diseases in the scope of compulsory health entry examinations.
The instruments proved useful to assess the health care situation of asylum-seekers in a decentralized health care system. Repeated surveys with a focus on selected domains of the questionnaire could help monitor the health care situation on a regular basis.
德国缺乏针对寻求庇护者医疗保健状况的全国性研究，但决策者对这类信息的需求日益增加。
本研究旨在从德国公共卫生当局的角度，评估在从接待中心到社区住所的连续过程中，与寻求庇护者医疗保健相关的结构、流程和需求。
开展了一项全国性的横断面混合方法调查。邀请了德国所有公共卫生当局的负责人（N = 389）填写一份标准化问卷，内容涉及：（1）医疗程序和筛查；（2）预防和健康促进；（3）沟通；（4）文件记录和信息；（5）协调；（6）结构资源和需求。定量调查辅以定性半结构化访谈。
共有123名公共卫生当局负责人（回复率：31.6%）完成了问卷，29人接受了访谈。改善医疗保健状况的优先领域包括更好地协调和规范医疗服务、提高疫苗接种能力、标准化文件记录、更好地进行健康信息交流（符合数据保护法），以及在强制健康入境检查范围内更关注少数几种相关传染病。
这些工具被证明有助于评估分散式医疗保健系统中寻求庇护者的医疗保健状况。针对问卷选定领域进行重复调查有助于定期监测医疗保健状况。
