title: Access to healthcare for undocumented migrants with communicable diseases in Germany: a quantitative study.
abstract: BACKGROUND
  Migrants without residence permits are de facto excluded from access to healthcare in Germany. There is one exception in relevant legislation: in the case of sexually transmitted infections and tuberculosis, the legislator has instructed the local Public Health Authorities to offer free and anonymous counseling, testing and, if necessary, treatment in case of apparent need. Furthermore, recommended vaccinations may be carried out free of charge. This study intends to comprehensively capture the services for undocumented migrants at Public Health Authorities in Germany.
  
  
  METHODS
  An e-mail survey of all Local Public Health Authorities (n = 384) in Germany was carried out between January and March 2011 using a standardized questionnaire.
  
  
  RESULTS
  One hundred thirty-nine of 384 targeted local Health Authorities completed the questionnaire (36.2%), of which approximately a quarter (n = 34) reported interaction with 'illegal' immigrants. Twenty-give authorities (18.4%) gave the indication to carry out treatment. This outpatient treatment option is mostly limited to patients afflicted with sexually transmitted infections with the distinct exception of human immunodeficiency virus/acquired immune deficiency syndrome.
  
  
  CONCLUSIONS
  The study highlights the gap between legislation and the reality of restricted access to medical services for undocumented migrants in Germany. It underlines the need of increased financial and human resources in Public Health Authorities and, overall, the simplification of national legislation to assure the right to healthcare.
authors.affiliation: Friedrich-Alexander-University Erlangen-Nuremberg, Institute for History of Medicine and Medical Ethics maren.mylius@ethik.med.uni-erlangen.de.
authors.forename: Maren
authors.initials: M
authors.lastname: Mylius
authors.affiliation: Friedrich-Alexander-University Erlangen-Nuremberg, Institute for History of Medicine and Medical Ethics.
authors.forename: Andreas
authors.initials: A
authors.lastname: Frewer
mesh_terms: D003140:Communicable Disease Control / Q000191:economics / Q000458:organization & administration*; D003141:Communicable Diseases / Q000188:drug therapy*; D003376:Counseling; D005858:Germany / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration; D009111:Local Government; D011635:Public Health Administration; D012111:Residence Characteristics; D012749:Sexually Transmitted Diseases / Q000188:drug therapy; D014171:Transients and Migrants; D014376:Tuberculosis / Q000188:drug therapy