[Prevalence of People without Health Insurance and Interventions of Hospital Social Work at the University Hospital of Essen].

OBJECTIVE

In Germany, a number of people remain without health insurance, thus unable to access the formal health care sector. Reliable statistics covering the prevalence and description of uninsured patients, especially in the inpatient health care sector, are still lacking. Our study therefore aimed to assess the prevalence of uninsured patients at University Hospital of Essen over a period of five years. Furthermore, we report rates of identification of cost providers and refunded disbursement.

METHODS

Uninsured patients from 2014-2018 were included. We defined the following subgroups for stratification according to the right of access to health insurance: patients with right of access to health insurance in Germany, EU citizens, patients from third countries, patients without residence permit status.

RESULTS

Data of 918 uninsured patients (mean age 31.3±20.6 years, 52,1% men) from 2014 to 2018 were evaluated. Over five years, identification of cost provider was successful in 74% and yielded in a total refund of 7.5 million Euros. In most instances, patients were treated in the gynaecological and maternity clinic (20%), paediatric clinic (17%), orthopaedic clinic and trauma surgery (14%) and the clinic for internal medicine (13%).

CONCLUSION

Our study shows that there are still people in Germany who do not have health insurance. Referring to the inpatient health care sector, results show that it is possible to calculate treatment costs, to identify cost providers and to refund medical costs. To apply target group-specific approaches in practice, more research is needed addressing both causes and risk factors. The availability of comprehensive data could improve discussions at a political level on medical compensation not available to patients.