Health-Care Utilization of Refugees: Evidence from Austria

Abstract

European countries have experienced significant inflows of migrants in the past decade, including many refugees from regions engaged in armed conflicts. Although previous research on migrant health has largely focused on economic migration, empirical evidence on refugee health is sparse. This article uses administrative data from Austria to differentiate between economic migrants and refugees and to analyze both groups’ health-care expenditures in comparison to natives. We contribute to the literature on migrant health in several dimensions. First, we follow economic migrants and refugees over the first five years after arrival and show different health-care expenditure patterns among migration groups. In contrast to patterns for economic migrants, we find substantially higher health-care expenditures for refugees compared to natives, especially in the first year after arrival. This difference is not explained by specific diseases or individual refugee groups, indicating refugees’ generally inferior health status in the first years of settlement. Second, we focus on the health effects of granting asylum and find that the expenditure differences decrease after a positive asylum decision. In the last part, by using refugees’ quasi-random placement as a natural experiment, we show that the local health-care sector's characteristics do not have a significant effect on expenditure levels. The findings highlight the importance of distinguishing between migrant groups in the analysis of health-care utilization and show that the time spent in the host country, as well as legal status, have a substantial impact on migrants’ health-care utilization.