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

Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusions

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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References

  • Allerbeck KR, Hoag WJ (1985) Wenn deutsche Ausländer befragen. Zeitschrift für Soziologie 14:241–246

    Article  Google Scholar 

  • Al-Shaqsi S (2010) Models of international emergency medical service (EMS) systems. Oman Med J 25:320–323

    Article  PubMed  PubMed Central  Google Scholar 

  • Aminzadeh F, Dalziel WB (2002) Older adults in the emergency department: a systematic review of patterns of use, adverse outcomes, and effectiveness of interventions. Ann Emerg Med 39:238–247

    Article  PubMed  Google Scholar 

  • Anson O, Carmel S, Levin M (1991) Gender differences in the utilization of emergency department services. Women Health 17:91–104

    CAS  Article  PubMed  Google Scholar 

  • Blohm M, Diehl C (2001) Wenn Migranten Migranten befragen. Zum Teilnahmeverhalten von Einwanderern bei Bevölkerungsbefragungen. Zeitschrift für Soziologie 30:223–242

    Article  Google Scholar 

  • Borde T, David M (2003) Gibt es Besonderheiten bei der Inanspruchnahme klinischer Notfallambulanzen durch Migrantinnen und Migranten? In: Borde T, David M (eds) Gut versorgt?. Migrantinnen und Migranten im Gesundheits- und Sozialwesen, Mabuse

    Google Scholar 

  • Correa-Velez I, Sundararajan V, Brown K, Gifford SM (2007) Hospital utilisation among people born in refugee-source countries: an analysis of hospital admissions, Victoria, 1998–2004. Med J Aust 186:577–580

    PubMed  Google Scholar 

  • Dingoyan D, Schulz H, Mosko M (2012) The willingness to participate in health research studies of individuals with Turkish migration backgrounds: barriers and resources. Eur Psychiatry 27(Suppl 2):4–9

    Article  Google Scholar 

  • Gabler S, Häder S (2002) Idiosyncrasies in telephone sampling-the case of Germany. Int J Pub Opin Res 14:339–345

    Article  Google Scholar 

  • Harkness JA (2008) Comparative survey research: goals and challenges. In: de Leeuw JJ, Hox JJ, Dillmann DA (eds) International handbook of survey methodology. Lawrence Erlbaum Associates, New York, pp 56–77

    Google Scholar 

  • Hjern A, Haglund B, Persson G, Rosen M (2001) Is there equity in access to health services for ethnic minorities in Sweden? Eur J Pub Health 11:147–152

    CAS  Article  Google Scholar 

  • Hussain-Gambles M, Atkin K, Leese B (2004) Why ethnic minority groups are under-represented in clinical trials: a review of the literature. Health Soc Care Community 12:382–388

    Article  PubMed  Google Scholar 

  • Killinger E (2009) Die Besonderheiten der Arzthaftung im medizinischen Notfall. Springer, Berlin

    Book  Google Scholar 

  • Koch G (2008) Zur Entwicklung Interkultureller Kompetenz im Studium. Theoretische und pragmatische Ansatzpunkte. In: Bahl A (ed) Kompetenzen für die globale Wirtschaft Begriffe—Erwartungen—Qualifikationsansätze. Bertelsmann Verlag, Bielefeld, pp 189–207

    Google Scholar 

  • Li G, Lau JT, McCarthy ML, Schull MJ, Vermeulen M, Kelen GD (2007) Emergency department utilization in the United States and Ontario, Canada. Acad Emerg Med 14:582–584

    Article  PubMed  Google Scholar 

  • Mayring P (2010) Qualitative Inhaltsanalyse: Grundlagen und Techniken. Beltz, Weinheim

    Book  Google Scholar 

  • Norredam M, Krasnik A, Sorensen TM, Keiding N, Michaelsen JJ, Nielsen AS (2004) Emergency room utilization in Copenhagen: a comparison of immigrant groups and Danish-born residents. Scand J Pub Health 32:53–59

    Article  Google Scholar 

  • Norredam M, Mygind A, Nielsen AS, Bagger J, Krasnik A (2007) Motivation and relevance of emergency room visits among immigrants and patients of Danish origin. Eur J Pub Health 17:497–502

    Article  Google Scholar 

  • Ong BN, Yip MP, Feng S, Calhoun R, Meischke HW, Tu SP (2012) Barriers and facilitators to using 9-1-1 and emergency medical services in a limited English proficiency Chinese community. J Immigr Minor Health 14:307–313

    Article  PubMed  Google Scholar 

  • Rue M, Cabre X, Soler-Gonzalez J, Bosch A, Almirall M, Serna MC (2008) Emergency hospital services utilization in Lleida (Spain): a cross-sectional study of immigrant and Spanish-born populations. BMC Health Serv Res 8:81

    Article  PubMed  PubMed Central  Google Scholar 

  • Schenk L (2002) Migrantenspezifische Teilnahmebarrieren und Zugangsmöglichkeiten im Kinder- und Jugendgesundheitssurvey. Gesundheitswesen 64:59–68

    Article  Google Scholar 

  • Schenk L, Neuhauser H (2005) Methodische Standards für eine migrantensensible Forschung in der Epidemiologie. Epidemiologie und Gesundheitsberichterstattung 48:279–286

    CAS  Google Scholar 

  • Sheikh M, Nugus PI, Gao Z, Holdgate A, Short AE, Al Haboub A, Macintyre CR (2011) Equity and access: understanding emergency health service use by newly arrived refugees. Med J Aust 195:74–76

    PubMed  Google Scholar 

  • Statistisches Bundesamt (2015) Bevölkerung und Erwerbstätigkeit. Bevölkerung mit Migrationshintergrund—Ergebnisse des Mikrozensus 2014. Statistisches Bundesamt, Wiesbaden

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Funding

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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Corresponding author

Correspondence to Diana Kietzmann.

Ethics declarations

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.

Informed consent

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). https://doi.org/10.1007/s00038-016-0904-y

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  • DOI: https://doi.org/10.1007/s00038-016-0904-y

Keywords

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