Project details

Background: People without proof of residence status as well as certain citizens inside the European Union and some people with German citizenship have no or limited access to adequate health care in Germany. In Bremen, the draft resolution on "securing medical and health care for people without health insurance and undocumented people in Bremen - a model project" was introduced in the Deputation for Health and Consumer Protection on 3.5.2022 to achieve three goals:

1. To provide access via treatment vouchers to people who are temporarily or permanently unable to access regularly billed health care.

2. To integrate a clearing system that enables these individuals to become part of the regular healthcare system.

3.     To establish low-threshold access and primary care services aimed at preventing or mitigating the progression of severe diseases by identifying and treating health problems at an earlier stage.

Since 15.8.2022, the "counseling and treatment center of the association for the promotion of health and medical care for uninsured and undocumented people in Bremen e.V." offers medical consultations and advice in clearing in its own premises. For further care, if necessary, treatment vouchers are issued, which can be redeemed with medical and non-medical providers.

Objectives: An evaluation will be conducted to decide on the continuation of the model beyond 2023, based on the results. The evaluation aims to achieve the following goals:

1. Analyzing the perspectives and needs of the clients with regard to access.
2. Quantitatively assessing the quality of care provided.
3. Recording satisfaction with the care processes.
4. Surveying perceived quality and appropriateness of the care.
5. Assessing the utilization of resources and economic aspects.

Methods: The evaluation will employ a combination of qualitative and quantitative methods. Semi-structured guided interviews will be conducted with staff from the counseling and treatment center, as well as with service providers. Additionally, questionnaires will be developed for staff, providers, and clients. Routine data collected at the counseling and treatment center will also be evaluated.