title: [How do asylum seekers experience access to medical care?]
abstract: BACKGROUND
  In Germany basic medical care for asylum seekers is organized outside the statutory health insurance system. Currently there are few empirically based statements on how asylum seekers experience their access to healthcare. The aim is therefore to evaluate their experiences with healthcare focussing on subjective health, utilisation and access to medical care, and experiences with medical care.
  
  
  METHODS
  Between August and November 2015, we performed 16 qualitative problem-oriented guided interviews with asylum seekers, who received or sought medical care in Saxony-Anhalt. The interpreter-assisted interviews were evaluated with content analysis.
  
  
  RESULTS
  Access begins with a voucher for medical treatment issued by the social security office. Asylum seekers experience that procedure as onerous and incapacitating. These experiences influence subjective health and utilisation of medical help. If their efforts for treatment certificates are rejected, people increasingly resign. If medical treatment is achieved, they experience medical staff mostly as competent and friendly, in spite of language difficulties and time pressure.
  
  
  CONCLUSIONS
  Reducing the "voucher bureaucracy" by uniform rules and practices may bring about a relief to access and utilisation of healthcare. Introducing an electronic health insurance card for asylum seekers would retransfer decision making about treatment needs from the welfare system into the medical system.
authors.affiliation: Institut für Sozialmedizin und Gesundheitsökonomie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland. Anke.Spura@med.ovgu.de.
authors.forename: Anke
authors.initials: A
authors.lastname: Spura
authors.affiliation: Institut für Sozialmedizin und Gesundheitsökonomie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kleinke
authors.affiliation: Institut für Sozialmedizin und Gesundheitsökonomie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
authors.forename: Bernt-Peter
authors.initials: BP
authors.lastname: Robra
authors.affiliation: Fachbereich Soziale Arbeit, Gesundheit und Medien, Hochschule Magdeburg-Stendal, Magdeburg, Deutschland.
authors.forename: Nadine
authors.initials: N
authors.lastname: Ladebeck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003144:Communication Barriers; D005260:Female; D005858:Germany / Q000453:epidemiology; D057220:Health Literacy / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data*; D012943:Social Security / Q000706:statistics & numerical data*; D014600:Utilization Review; D035862:Vulnerable Populations / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Asylum seekers; Healthcare research; Medical services accessibility; Medical services utilisation; Voucher for medical treatment