School of Public Health, Bielefeld University, Bielefeld, Germany.
Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.
Int J Public Health. 2023 Jun 21;68:1605578. doi: 10.3389/ijph.2023.1605578. eCollection 2023.
The study aims to investigate the significance of legal status for well-being and access to and use of needs-based health care by asylum seekers and refugees in Germany. Using a mixed-method-design, we first conducted a cross-sectional study to explore access to health care and unmet needs of refugees and asylum seekers and legal status. Data were analysed using descriptive statistics. For the qualitative study a heterogeneous sample was recruited from the quantitative data. Interviews were analysed using a deductive-inductive approach. Quantitative results showed that health care utilisation was associated with an unsecure legal status but not with unmet care needs. The in-depth qualitative study revealed that the legal status determines experiences of structural violence that can negatively affect well-being and associated access to health care. An insecure legal status can affect access to health care for refugees and asylum seekers. In order to improve health, changes in living conditions and the removal of access barriers are necessary.
本研究旨在探讨法律地位对德国寻求庇护者和难民的福祉以及获得和使用基于需求的医疗保健的意义。本研究采用混合方法设计，首先进行了一项横断面研究，以探讨难民和寻求庇护者的医疗保健获取情况以及未满足的需求和法律地位。使用描述性统计方法对数据进行分析。对于定性研究，从定量数据中招募了异质样本。使用演绎-归纳方法对访谈进行分析。定量结果表明，医疗保健的利用与不安全的法律地位有关，但与未满足的医疗保健需求无关。深入的定性研究表明，法律地位决定了结构性暴力的体验，这可能对福祉和获得医疗保健产生负面影响。不安全的法律地位可能会影响难民和寻求庇护者获得医疗保健。为了改善健康，需要改变生活条件和消除获得医疗保健的障碍。
