Background: The initial and intermediate-term access of refugees to healthcare in Germany is limited. A previous study showed that the obligation to request healthcare vouchers at the social security offices decreases the asylum seekers’ consultation rate of ambulant physicians. The introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers is considered skeptically by some municipalities and federal states, among other reasons due to the fear of an overuse of health care services by asylum seekers. The aim of this study is to further evaluate the data of the authors’ initial study with a new focus on inpatient care as well as a differentiation of the ambulant consultation rate into general practitioners and outpatient specialists. Methods: The now-differentiated consultation rate of the initial study as well as the asylum seekers’ use of inpatient care are compared to the values of the sex-and age-corrected autochthonous population as given by the German Health Interview and Examination Survey for Adults (DEGS1). A mean difference test (student’s t-test) is used for comparison and significance testing. Results: Asylum seekers who were in possession of the EHIC were significantly less likely to visit their ambulant general practitioners and specialists than the German autochthonous population. Simultaneously, this difference is partly compensated for by their more frequent use of impatient care. Conclusions: There is no indication that the EHIC leads to an overuse of healthcare services. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Electronic Health Insurance Card Access to healthcare Refugee health Prevention and medical care of refugees Refugees’ use of outpatient and inpatient medical care

patient care Germany hospital patient refugee public health service insurance health insurance human Insurance Coverage Refugees middle aged clinical assessment tool statistics and numerical data health service controlled study outpatient care Aged general practitioner North Rhine-Westphalia public access Government Programs Surveys and Questionnaires Young Adult asylum seeker Humans consultation male female Cities questionnaire population research electronic health record health services Article health care health care utilization city major clinical study adult age medical specialist government Ruhr health care system Fear sex Health Services Accessibility documentation health care delivery health survey