Between Borders and Viruses: A Time Series Analysis of Healthcare Use by Asylum-Seekers

Objective: In the recent period when the density of immigrants has increased globally, the necessity of analyzing immigrant behaviors and making interpretations accordingly has become evident. This study analyzes how the healthcare utilization behaviors of asylum-seekers and locals changed before and after the COVID-19 pandemic and how pandemic-related variables affect asylum-seekers' motivation. Methods: We examined whether the number of cases, deaths, and vaccinations in Turkey during the pandemic had a deterrent or attractive effect on hospital visits by asylum-seekers. Admissions to hospital departments (all medicine departments- 55 departments-) were used as the dependent variable. The short-term and long-term effects of explanatory variables on the dependent variable were estimated using the Autoregressive Distributed Lag (ARDL) model. Results: We found that the overall pandemic situation significantly impacted long-term healthcare use among asylum-seekers. In the short term, only vaccines had a significant impact. We also found that asylum-seekers accounted for only 1% of total healthcare use, with the remaining 99% used by the locals. Conclusions: When the social and economic impact of asylum-seekers' healthcare services use is evaluated, it may be necessary to determine appropriate policies for these patients in non-pandemic periods and during pandemics. To prevent local’s reactions from growing, accurate data and the opportunities of the current situation can be conveyed to the public. Different marketing activities may need to be implemented for these patients, who can also constitute a target market as an opportunity for healthcare institutions. Vaccination policies should be carefully considered.