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(Non-)utilization of pre-hospital emergency care by migrants and non-migrants in Germany



This study was designed to explore the utilization and non-utilization of pre-hospital emergency care by migrants and non-migrants, and the factors that influence this behaviour.


A cross-sectional representative German survey was conducted in a sample of 2.175 people, 295 of whom had a migration background. An additional sample of 50 people with Turkish migration background was conducted, partially in the Turkish language. Apart from socio-demographics, the utilization of emergency services and the reasons for non-utilization were assessed.


Migrants had a higher utilization rate of pre-hospital emergency care (RR = 1.492) than non-migrants. Furthermore, migrants who were not born in Germany had a lower utilization rate (RR = 0.793) than migrants who were born in Germany. Regarding non-utilization, the most frequently stated reasons belonged to the categories initial misjudgment of the emergency situation and acting on one’s own behalf, with the latter stated more frequently by migrants than by non-migrants.


To prevent over-, under-, and lack of supply, it is necessary to transfer knowledge about the functioning of the medical emergency services, including first aid knowledge.

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The study was conducted as part of the project “Rescue, Aid and Culture—Intercultural Competence in Civil Protection II” and funded by the Federal Office of Civil Protection and Disaster Assistance, Germany (Grant-Number: BBK-III. 1-413-10-00-396).

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Correspondence to Diana Kietzmann.

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All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee (Ethics Commission of the University of Greifswald; 17/12/2013) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interests

We declare that we have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Kietzmann, D., Knuth, D. & Schmidt, S. (Non-)utilization of pre-hospital emergency care by migrants and non-migrants in Germany. Int J Public Health 62, 95–102 (2017).

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  • Pre-hospital emergency care
  • Utilization
  • Non-utilization
  • Migration background