Inequity at Emergency Departments. An Ethnographic Approach

Stéphanie Van Droogenbroeck

Onderzoeksoutput: Meeting abstract (Book)



Emergency departments in Belgium are obliged by law to help patients who seek medical attention. A mandatory health insurance –regulated by the federal government- covers 99% of the population. Although, most Belgian citizens have health coverage, lots of (illegal) immigrants lack insurance. Hence the question: are the uninsured treated differently or not at emergency departments?


An ethnographic study in two Belgian urban hospitals has been conducted. Hospital 1 is at the center of the capital (Brussels) and known for its patient population mostly without insurance, whereas hospital 2 is at the periphery of the capital and known for its patient population mostly with insurance. Patients with internal medical complaints at the emergency departments and the entire medical setting were observed. Semi-structured interviews were taken from patients and their family. These data are analyzed with the grounded theory approach. Some cases and the relevant literature will be discussed.

Results and Discussion

In hospital 2 (un)insured immigrants are often seen as “theatrically” overacting patients by the administrative personal and care givers. This prejudice can have negative consequences for the diagnostic process of the patients because of the label of “just overacting” that these patients receive. In hospital 1 uninsured (illegal) immigrants are sometimes perceived as equally overacting patients because they need a medical record in order to file for a residence permit. In addition, the context in hospital 1 is different from the context in hospital 2. Because of the relatively high number of uninsured patients, hospital 1 made a system to recognize the uninsured. They are literally labeled. This way it becomes possible for the health care provider to recognize these patients and, e.g., not to order expensive tests “because the patient will probably never pay his bill anyway”.


Uninsured immigrants are treated differently at different emergency departments. Even insured immigrants are by the prejudice of perceived “theatrical” behavior, missing out on real treatment for their complaints.

Keywords: Insurance, Emergency Medicine, Immigrants, Ethnography
Originele taal-2English
TitelISIH 6th International In Sickness and In Health Conference
StatusPublished - 2015
EvenementISIH 6th International In Sickness and In Health Conference - Palma de Mallorca, Spain
Duur: 10 jun 201512 jun 2015


ConferenceISIH 6th International In Sickness and In Health Conference
StadPalma de Mallorca


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