Factors associated with communicative and financial barriers to healthcare utilization among people with selected citizenships in Germany: results from a nationwide cross-sectional study

Background Research has shown that migrants in Germany face various barriers to healthcare access, including communicative and financial barriers. This study examined which sociodemographic, migration-related, and psychosocial factors are associated with these barriers in order to better understand lower healthcare utilization among migrants. Methods We used data from the nationwide cross-sectional health interview survey GEDA Fokus, which included people with Croatian, Italian, Polish, Syrian, or Turkish citizenship living in Germany. Descriptive, univariable, and multivariable analyses were conducted separately for communicative and financial barriers while accounting for relevant social factors. Results Of the 6,038 participants, 16.2% reported communicative barriers and 9.0% reported financial barriers to healthcare utilization. According to the regression analyses, gender, age, German language proficiency, and self-reported experiences of racist discrimination were associated with communicative barriers. For financial barriers, associations with gender, educational level, and experiences of discrimination due to the socioeconomic situation were found. Conclusion The results indicate that demographic, socioeconomic, migration-related, and psychosocial factors are associated with communicative and financial barriers to healthcare utilization. Gender and experiences of discrimination were significantly associated with both communicative and financial barriers. In practice, the provision of qualified translation and interpretation services, anti-discrimination and awareness training for healthcare staff, and the expansion of low-threshold, financially accessible services could help promote more equitable access to healthcare among migrants.