371 Access restricted: Perspectives of immigrants and refugees on German healthcare

Abstract EP2.4, e-Poster Terminal 2, September 4, 2025, 11:35 - 12:55 According to a growing body of international literature, racism has been recognized as an important determinant of health. Moreover, research shows that healthcare itself is not free from racism at interpersonal, institutional, and structural levels. This presentation explores the perspectives of immigrants living in Germany, collected as part of the study on racism in the German healthcare system (RiGeV), supported by funding from the Federal Ministry of Education and Research. The presentation will focus on the results of 22 episodic narrative interviews conducted at Fulda University of Applied Sciences, as well as 309 online questionnaires collected by Witten/Herdecke University. In both qualitative and quantitative parts of the study, respondents report feeling that they do not receive the same access to healthcare as German patients. All respondents describe not being taken seriously, receiving abbreviated explanations about necessary procedures and aftercare, receiving (preliminary) diagnoses based on their gender and country of origin, and even being completely refused medical examination and treatment. Firstly, patients face barriers due to, for example, unspoken rules of German bureaucracy, or the need to book appointments in German by telephone. Further, patients report facing racism from gatekeepers in the healthcare system – receptionists, emergency hotline workers and personnel in emergency rooms – frequently resulting in being denied access to medical examinations, treatments and prescriptions, even in cases of acute illness. In addition, asylum seekers are only legally entitled to emergency healthcare and face bureaucratic hurdles that further impede their access to healthcare. The presentation will explore the implications of these forms of racism and restrictions on patients’ access to healthcare. Possible solutions focusing on gatekeepers of the healthcare system will also be discussed.