Bozorgmehr Kayvan, Erdmann Stella, Rohleder Sven, Jahn Rosa
Department of Population Medicine & Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany.
Section Health Equity Studies & Migration, Heidelberg University Hospital, Heidelberg, Germany.
Nat Commun. 2025 Jul 24;16(1):6808. doi: 10.1038/s41467-025-61876-x.
The COVID-19 pandemic may have affected morbidity patterns of residents in refugee centres, but empirical evidence is scarce. We utilised linked data from a health surveillance network in refugee centres of three German federal states, employing a quasi-experimental design to examine the effects of the COVID-19 pandemic on newly diagnosed medical conditions. Doctors coded routine diagnoses on-site in healthcare facilities for refugee patients. Our analysis encompasses the timeframe from October 2018 to April 2023 and includes individual-level data for 109,175 refugees. This data resulted in 76,289 patient-months across 21 refugee centres, with a total occupancy of 144,012 person-months. Here, we employ segmented regression analyses, adjusting for time trends, socio-demographic factors, occupancy, and centre characteristics, to evaluate the COVID-19 pandemic's impact on incident diagnosis patterns among refugees. We show how the COVID-19 pandemic altered diagnosis patterns among refugees in German centres. Notably, incidents of injuries, mental disorders, psychotherapeutic drug prescriptions, and genitourinary diseases rose, while respiratory diseases decreased, later rebounding. An increase in injury-related diagnoses suggests heightened violence experiences during flight or in centres. Mental disorder diagnoses and psychotherapeutic drug prescriptions rose, reflecting pandemic-related stressors and the pandemic's multifaceted impact on refugee health.
新冠疫情可能影响了难民中心居民的发病模式，但实证证据匮乏。我们利用了德国三个联邦州难民中心健康监测网络的关联数据，采用准实验设计来研究新冠疫情对新诊断疾病的影响。医生在医疗机构为难民患者现场编码常规诊断。我们的分析涵盖2018年10月至2023年4月的时间范围，包括109,175名难民的个体层面数据。这些数据在21个难民中心产生了76,289个患者月，总占用时长为144,012人月。在此，我们采用分段回归分析，对时间趋势、社会人口因素、占用情况和中心特征进行调整，以评估新冠疫情对难民中疾病诊断模式的影响。我们展示了新冠疫情如何改变了德国难民中心的诊断模式。值得注意的是，受伤、精神障碍、心理治疗药物处方和泌尿生殖系统疾病的发生率上升，而呼吸道疾病减少，随后又有所反弹。与受伤相关的诊断增加表明在逃亡途中或在中心内暴力经历增多。精神障碍诊断和心理治疗药物处方增加，反映了与疫情相关的压力源以及疫情对难民健康的多方面影响。
