Impact of the COVID-19 pandemic on incident diagnoses in German refugee centres 2018 to 2023

Abstract

The COVID-19 pandemic may have affected morbidity patterns of residents in refugee centres, but empirical evidence is scarce. We utilised linked data from a health surveillance network in refugee centres of three German federal states, employing a quasi-experimental design to examine the effects of the COVID-19 pandemic on newly diagnosed medical conditions. Doctors coded routine diagnoses on-site in healthcare facilities for refugee patients. Our analysis encompasses the timeframe from October 2018 to April 2023 and includes individual-level data for 109,175 refugees. This data resulted in 76,289 patient-months across 21 refugee centres, with a total occupancy of 144,012 person-months. Here, we employ segmented regression analyses, adjusting for time trends, socio-demographic factors, occupancy, and centre characteristics, to evaluate the COVID-19 pandemic’s impact on incident diagnosis patterns among refugees. We show how the COVID-19 pandemic altered diagnosis patterns among refugees in German centres. Notably, incidents of injuries, mental disorders, psychotherapeutic drug prescriptions, and genitourinary diseases rose, while respiratory diseases decreased, later rebounding. An increase in injury-related diagnoses suggests heightened violence experiences during flight or in centres. Mental disorder diagnoses and psychotherapeutic drug prescriptions rose, reflecting pandemic-related stressors and the pandemic’s multifaceted impact on refugee health.