Mylius Maren, Dreesman Johannes, Zühlke Christel, Mertens Elke
Niedersächsisches Landesgesundheitsamt, Abteilung 2: Infektionsepidemiologie, Roesebeckstr. 4-6, 30449, Hannover, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2019 Aug;62(8):927-934. doi: 10.1007/s00103-019-02972-4.
In 2014, the parliament of the federal state of Lower Saxony (Germany) implemented a three-year pilot project to reduce barriers to healthcare for undocumented migrants. For this purpose, two counselling centres (CCs) were established (Hanover and Goettingen), where undocumented migrants receive treatment vouchers for the medical treatment of acute medical issues, check-ups, and vaccination.
We assessed which medical services were used in order to identify needs and recommend specific improvements to policymakers.
We analysed CC data from the first two years after starting the project (1 February 2016-31 January 2018). We described demographic characteristics of attendees, reasons for attendance, and medical diagnoses. Additionally, we carried out explorative interviews on the subject of vaccination in one CC (February-May 2018).
In total, 236 undocumented migrants received 698 vouchers. The number of vouchers issued increased over time: from 17/month (February-July 2016) to 44/month (August 2017-January 2018); 56% were female and 16% were younger than 18 years. Half of the women (66/132) attended for prenatal care. In 4% (9/236) of attendees vaccinations were given. Of 25 people approached for explorative interviews, 18 participated. All of them were generally open about vaccinations; 12 (67%) had already received vaccinations at some point.
The increasing use of CCs shows the need for low-threshold healthcare access, particularly for vulnerable groups (children, pregnant women). Vaccinations were rarely performed. Strengthening vaccination literacy by providing more information to both physicians and attendees can increase vaccination uptake.
2014年，德国下萨克森州议会实施了一项为期三年的试点项目，以减少无证移民获得医疗服务的障碍。为此，设立了两个咨询中心（汉诺威和哥廷根），无证移民可在那里获得用于治疗急性医疗问题、体检和疫苗接种的治疗券。
我们评估了所使用的医疗服务，以便确定需求并向政策制定者推荐具体的改进措施。
我们分析了项目启动后头两年（2016年2月1日至2018年1月31日）咨询中心的数据。我们描述了就诊者的人口统计学特征、就诊原因和医疗诊断。此外，我们在一个咨询中心就疫苗接种问题进行了探索性访谈（2018年2月至5月）。
共有236名无证移民获得了698张治疗券。发放的治疗券数量随时间增加：从每月17张（2016年2月至7月）增至每月44张（2017年8月至2018年1月）；56%为女性，16%年龄小于18岁。一半的女性（66/132）因产前护理前来就诊。4%（9/236）的就诊者接受了疫苗接种。在被邀请参加探索性访谈的25人中，18人参与。他们所有人总体上对疫苗接种持开放态度；12人（67%）曾在某个时候接种过疫苗。
咨询中心使用量的增加表明需要提供低门槛医疗服务，特别是为弱势群体（儿童、孕妇）。疫苗接种很少进行。通过向医生和就诊者提供更多信息来提高疫苗接种知识水平，可以增加疫苗接种率。
