Background
Methods
Study design
Data analysis
Sample characteristics
Interview | Age | Gender | Interview language | Living in Germany since | Family situation (Living in Germany with family members or alone) | Languages spoken | Living conditions |
---|---|---|---|---|---|---|---|
1 | 29 | Female | English | March 2022 | With family members | Ukrainian, Russian, English, German | Private accommodation |
2 | 32 | Female | German | March 2022 | With family members | Ukrainian, Russian, German | Private accommodation |
3 | 70 | Male | Ukrainian | April 2022 | With family members | Ukrainian, Russian, Romanian | Private accommodation |
4 | 70 | Female | Ukrainian | March 2022 | Alone | Ukrainian, Russian | Private accommodation |
5 | 60 | Female | Ukrainian | March 2022 | Alone | Ukrainian, Russian | Private accommodation |
6 | 39 | Male | Ukrainian | July 2022 | Alone | Ukrainian, Russian, English | Private accommodation |
7 | 66 | Female | Ukrainian | August 2022 | Alone | Ukrainian, Russian | Institutional accommodation |
8 | 40 | Male | Ukrainian | April 2022 | With family members | Ukrainian, Russian, English | Private accommodation |
9 | 32 | Female | English | March 2022 | With family members | Ukrainian, Russian, English | Private accommodation |
10 | 38 | Female | German | March 2022 | With family members | Ukrainian, Russian, English, German, Italian | Private accommodation |
Results
“So the first thing that comes to my mind and I think is very good, I got the insurance and immediately got the invitations for examinations. Mammography and colonoscopy. What I have never experienced in Ukraine like this.” (I5)
Differences between the German and the Ukrainian healthcare system
Pathways and structure of the healthcare system
“I had a GP in Ukraine and then another private doctor and I communicated with both of them. Depending on the time (…) and then, because I had money, I got insurance also.” (I5)
“So suppose you call and it is said that the doctor can only come the day after tomorrow, but you urgently want him to come today, then you can pay money so that he comes today. Which is also not very expensive, so the equivalent of about ten euros.” (I6)
“If I have a fever or something then I can contact my doctor conveniently via Viber or WhatsApp. I text my doctor, my daughter is sick, she can’t eat and drink and she has a fever, what should I do, and the doctor writes what I should do. For example, you have to go to the hospital now, or go to the pharmacy and buy such tablets.” (I2)
Health insurance
“(…) I don’t have this system in Ukraine because we don’t have obligatory health insurance. People in Ukraine don’t have this system. That’s why they can pay money for the first visit or for next visits and just came to the doctor and have health (…) treatment. (…) You just need to pay money and go to doctor.” (I1)
“Concerning the pediatrician. I can always call him and somehow ask him what medication I have to give my children now or what I should do when she feels ill. But I always send money in return. That means it’s always about money. And if you don’t do it, then nobody cares about you in the health system.” (I7)
Waiting times
“(…) So this is long, long, long everywhere. You need to wait for an appointment, you need to wait in a waiting room. You will need to wait. Yeah, I understand. It’s different from Ukrainian system, but, yes, sometimes it’s exhausting.” (I1)
“She called several doctors nearby, dermatology yes, and the earliest appointment was only in three months. And what did she do? She went to Ukraine. We can go to Ukraine. And she bought a ticket in the bus, and went to city A by bus, and she did everything for one day. In the clinic she made laser, she had all blood tests. In the morning she had all the results.” (I2)
Prescription of medication and vaccination
“But in Ukraine it is really common (…) when my kids are sick, I always got a prescription with total list of pills, even if it is like common fever or something like that.” (I1)
“She (the GP) said to me that my daughter must drink more tea and I will be honest with you, I called to my friends. They lived in (city in Germany) and I asked them to call my doctor in Ukraine so I can find an antibiotic.” (I9)
“But what I did here, for example, the doctor here immediately offered to do so and so many vaccinations. After sixty years. And we never got such an offer in Ukraine.” (I3)
Information and support needs
“We have some webs, there is this group in Telegram (…) and we have the big, big list and people ask maybe who knows some gynecologist or something like this and people help.” (I9)
Thematic area | Information needs and wishes | Citations |
---|---|---|
Waiting times | • informing about long waiting times for appointments, treatments and in doctor’s offices/clinics | “I think for Ukrainian people it’s important because they are used to another approach. They used to have help right now, right now. And for them I think it will be important to know that they need to wait, always wait. And don’t panic, just wait.” (I1) |
• waiting times during medical emergencies | “This time waiting for the appointments (…) if I wanted to go to the gynecologist and get an appointment and if I would be young, pregnant and only had an appointment in three months- how does that work here?” (I5) | |
• addressing and easing fears and concerns | “And for them I think it will be important to know that they need to wait, always wait. And don’t panic, just wait.” (I1) | |
Communication | • informing refugees about the requirement to attend medical consultations with an interpreter | “Without a translator, it would be really bad. Because a lot of doctors here won’t accept anyone without a translator.” (I8) |
• improving access to (professional) interpreters and covering costs | “A paid interpreter would have helped. Because first of all, there aren’t very many here in city B, and if there are, they have their own lives and have to take care of other refugees here. Then it is also unpleasant to always have to ask them.“ (I8) | |
• where to find interpreters | “I tried to find (a translator) in social media groups, in social groups, where other people from Germany are who tried to help Ukrainian people.“ (I1) | |
• emphasizing the importance of language courses | “If you don’t speak the language, of course you have to find someone to help you. It can’t be an interpreter, that costs a lot of money, but many Ukrainian people complete a B1 course in a month or two, which is enough to hold a conversation and say something.“ (I2) | |
• interpreters can also assist in explaining the healthcare system | “And my idea was that someone sits in the town hall during working hours, with whom every Ukrainian can make an appointment (…) and can also explain the system better.” (I8) | |
• if possible, take medical documents with you or have them translated in Ukraine | “And I told her that she should take all the documents and all the medical documents if she has problems with health. And if it is possible, she should have the vaccination certificate translated in Ukraine, because it is faster and cheaper than here, because she also has a daughter. And at school they need this.“ (I2) | |
Pathways in the healthcare system | • explaining the general practitioner system, where the general practitioner (GP) serves as the primary point of contact | “And the doctor says no, no, you’ve come to the wrong doctor, please go to your GP. Then we first have to find out who the GP is (…)” (I5) |
• referral system from GPs to other specialists | “But that was actually strange to me, that if I wanted to go to the orthopedist, I should still go to the GP, even though I knew that I wanted to go to the orthopedist.” (I5) | |
• guidance on how to locate doctors in Germany | “We have some webs, there is this group in Telegram I think. Yes, Ukrainian-her name is Ukrainian people in City X or something like this and we have the big, big list and people ask maybe who knows some gynecologist or something like this and people help.” (I9) | |
• how to get medical appointments | “Personally, I would have been interested in how I could get to an orthopaedist, for example? What is needed for that? Or to a doctor who examines veins.” (I4) | |
Health insurance | • providing information on the German health insurance system, including its benefits | “So now I know because I’ve experienced it myself, the first, very first question is insurance. (…)The person can’t just turn up and say I want to see a doctor. It has to be via registration and insurance. Because only when you are insured you can get help from anyone, medical help.” (I4) |
• how to get access, an insurance card, who to turn to | “ So for me personally it (the membership to a an insurance company) took so long because when I applied I was still doing a mini-job at the time. And I thought that I had something to do with the JobCentre and I registered with the JobCentre even though I was a pensioner.“ (I4) | |
• understanding what costs and health services are covered by insurance | “(…) what the insurance will cover. So whenever I go to the doctor, the question is always “Yes, does the insurance cover it or doesn’t it cover it?” And I don’t know who the contact person would be (…)” (I6) | |
Medication supply | • high-quality medications in Germany with contents matching package claims | “And that the drugs here are good and that a lot is covered by insurance. Because in Ukraine, people are prescribed drugs that don’t work at all. Because they are poorly manufactured. And that is not the case here.” (I7) |
• medication intake is often assessed for necessity beforehand, e.g. in case of antibiotics | “So it was like this, I felt like I had eye problems (…) And I was first assigned a machine to measure my blood pressure during the day. And only then was I given the medication I had to take.” (I5) |