جستجوی مقالات مرتبط با کلیدواژه « asylum seekers » در نشریات گروه « پزشکی »

Conducting research in hard-to-reach populations such as applicants for international protection (AIPs) brings along a number of research challenges. This is especially true for sexual violence (SV) research.

We developed a study design with the intent to reach AIPs in a randomized and anonymous manner including potential illiterate respondents as well, while avoiding as much bias as possible. However, this method was developed just before the entry into force of the new European General Data Protection Regulation (GDPR), upon which important new research challenges emerged.

This paper describes the original study design developed to estimate SV prevalence in AIPs in Belgium. We discuss the impact of the GDPR on the recruitment strategy applied to conduct a survey on SV in a randomly selected sample of AIPs, the adapted approach to conduct the study beyond GDPR and lessons learned for future research on sensitive topics in hard-to-reach populations such as AIPs.

To achieve reliable prevalence numbers and provide high-quality data on SV in AIPs while respecting the GDPR regulations, studies will require an approach that has become significantly more time consuming and resourceintensive to implement.

In debates on asylum-seekers’ access to healthcare it is frequently claimed that restrictions are necessary to prevent unduly high health service utilization and costs. Within Germany, healthcare provision for asylum-seekers varies across the different states. Berlin’s authorities removed some barriers to healthcare for asylum-seekers by introducing an electronic health insurance card (HIC) in 2016. We used the HIC introduction in Berlin as an opportunity to investigate the effects of improved healthcare access for asylum-seekers on the local health system.

The study applied a mixed-methods design. A cost analysis compared expenses for outpatient and inpatient health services for asylum-seekers before and after the HIC introduction, based on aggregate claims data and information on expenses for humanitarian healthcare provision that were retrieved from the Berlin authorities. Semi- structured interviews with 12 key informants explored organizational effects like administrative workloads and ethical dilemmas for staff. We performed a content analysis and used respondent validation to enhance the accuracy and trustworthiness of our results.

The HIC has reduced bureaucratic complexity and administrative workloads; it has enabled unprecedented financial transparency and control; and it has mitigated ethical tensions. All the while, average per person expenses for outpatient health services have declined since the HIC introduction. However, our cost analysis also indicates a rise in the utilization and costs of inpatient care.

The HIC introduction in Berlin suggests that the removal of barriers to healthcare for asylum-seekers can create win-win-situations by reducing administrative workloads, advancing financial transparency, and mitigating ethical tensions, whilst cutting the costs of outpatient healthcare provision. Removing barriers to healthcare thus appears to be a more prudent policy choice than maintaining mechanisms of restriction and control. However, high inpatient care utilization and costs warrant further research.