The war in Ukraine has led millions of Ukrainians to seek protection in other parts of Europe, with around 48,000 receiving residence permits to live in Denmark ‒ permits which also grant access to Danish healthcare.
However, two new studies from Copenhagen University show that access on paper is not the same as real access, with many Ukrainians struggling with language barriers and feeling like their Danish doctors dismiss their issues or do not care about them.
'Struggling to navigate the system and get help'
"Its surprising, because special measures have been taken for Ukrainian refugees in particular," Marie Nørredam, professor of migration and health research at Copenhagen University's Department of Public Health, wrote in a press statement.
"Despite this, we are seeing that many of them are struggling to navigate the system and get the help they need."
The studies are based on a survey of 540 Ukrainian refugees in the capital region, as well as a number of interviews. The researchers admit that it is not representative of all Ukrainians in Denmark.
Only 17 percent of those answering the survey said that they felt well-informed about Danish healthcare, with 36 percent saying that they have needed medical treatment which they did not receive within the past year.
The survey and interviews were carried out between May and October 2023 ‒ more than a year after most of those involved arrived in Denmark.
Culture clash and 'gatekeeper model'
According to researchers, many found the egen læge system, where patients are allocated a particular doctor, frustrating.
"Among other things short consultations, a focus on one issue at a time and reluctance to prescribe certain times of medicine were interpreted in some cases as a dismissive or showing that doctors did not care," said Maria Marti Castaner, associate professor of public mental health at the Department for Public Health.
She added that this is in many ways a sign of a cultural clash.
"There's a fundamental difference in how the Danish and Ukrainian healthcare systems work," she said. "Frustrations occur when there is a mis-match between their expectations of Danish healthcare and the reality they meet."
She described the Danish model as a "gatekeeper model", where the egen læge or individual doctor decides whether to refer patients to a specialist, and that this can be a clash for people coming for a system where it is easier to access tests or specialists without going through your personal doctor first.
On top of this, researchers said, the language barrier was an issue, with 25 percent saying they took a professional interpreter to appointments, 27 percent saying they used Google Translate and 24 percent saying they received help from friends or family.
"Language can be a barrier for many Ukrainians, who often don't speak Danish or English ‒ both when contacting a doctor and during the consultation. So it's perhaps easier to use networks or systems you already know," Marie Nørredam said.
"Many Ukrainian refugees said that they ordered medicine from other countries, while others found Ukrainian doctors in Denmark or travelled to Ukraine for treatment," she said.
Almost three quarters, 72 percent, of respondents said they had ordered medicine from Ukraine, while 37 percent said they had contacted a Ukrainian doctor.
"This can be problematic if the Danish system is not following up with patients who have chronic illnesses," Nørredam said. "They risk not receiving the help they need, their mental or physical health worsening, or even that we only come into contact with them when they've fallen through the net."
'This would benefit people who migrate to Denmark in general'
In order to improve the situation, the researchers said that Denmark needs to improve messaging for Ukrainians and other new arrivals to the country.
"Ukrainian refugees tell us that when the reasoning behind the healthcare system is explained, it solves some of their frustration and adds to confidence in the system. When doctors spent more time and had more of a holistic approach, that also built confidence," Maria Marti Castaner said.
"We can see a lot of the same issues among refugees who come to Denmark from other countries who try and navigate our healthcare system without being able to speak the language," she added. "For that reason it would benefit other groups of refugees, and people who migrate to Denmark in general, if more measures were taken to improve these areas."
What were your first impressions or experiences of Danish healthcare? Do you recognise any of the issues raised by the Ukrainians in the study? Let us know in the comments below.
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