Mohammadzadeh Zahra, Jung Felicitas, Lelgemann Monika
Referat Migration und Gesundheit, Gesundheitsamt Bremen, Horner Str. 60-70, 28203, Bremen, Deutschland.
Gesundheitsberichterstattung, Gesundheitsamt Bremen, Bremen, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016 May;59(5):561-9. doi: 10.1007/s00103-016-2331-x.
The Bremen model recognizes that refugee health care has to go beyond merely checking for the prevalence of contagious diseases. Elementary health care offered in the reception centre and transitory facilities is based on voluntary acceptance by the refugees. At the same time, legal requirements for the medical reception of refugees are observed. In addition, doctors performing the initial medical examination are enabled to cover acute care on the spot. During the preliminary phase of immigration refugees are allowed to see a doctor in their facility repeatedly. After a certain time, they are provided with a health card permitting limited access to regular care outside of their facility. The current rise of refugee numbers affects the situation of Bremen health care for adult as well as juvenile refugees. In spite of the increase, health care standards are maintained by means of the health card. From 2011 to 2014, "Factors influencing health status and contact with health services" averaged 29.6 % in the health check data. Diseases of the respiratory system (18.1 %) and "symptoms, signs and abnormal findings not elsewhere classified" (16.9 %) ranked second and third, respectively. Diseases of the digestive system (6.1 %) of the musculoskeletal system (6 %) and of the skin and subcutaneous tissue (3.6 %) followed. Infectious diseases such as HIV infections, hepatitis or tuberculosis were seldom.
不来梅模式认识到，难民医疗保健不能仅仅局限于检查传染病的流行情况。在接待中心和临时设施中提供的基本医疗保健基于难民的自愿接受。与此同时，遵守难民医疗接待的法律要求。此外，进行初步体检的医生能够在现场提供急症护理。在移民的初步阶段，难民可以在其设施内多次就医。一段时间后，他们会获得一张健康卡，允许他们有限地利用设施外的常规医疗服务。目前难民人数的增加影响了不来梅成年和青少年难民的医疗保健状况。尽管人数有所增加，但通过健康卡维持了医疗保健标准。2011年至2014年，健康检查数据中“影响健康状况和与医疗服务接触的因素”平均为29.6%。呼吸系统疾病（18.1%）和“未另分类的症状、体征和异常发现”（16.9%）分别位居第二和第三。消化系统疾病（6.1%）、肌肉骨骼系统疾病（6%）和皮肤及皮下组织疾病（3.6%）紧随其后。诸如艾滋病毒感染、肝炎或结核病等传染病很少见。
