Are German patients burdened by the practice charge for physician visits ('Praxisgebuehr')? A cross sectional analysis of socio-economic and health related factors

Rückert, Ina-Maria; Bocken, Jan; Mielck, Andreas

doi:10.1186/1472-6963-8-232

Cited by 39 publications

(25 citation statements)

References 17 publications

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“…Dental health is the sector of German health care where supplementary payment in outpatient care is practised most extensively. A recent study has shown that this will keep patients not only from choosing good quality care, but also from going to the doctor at all (43), then utilization behaviour may be more pain-driven than motivated by prevention. Finally, education-related gradients are pointing to a lack of knowledge about dental hygiene and how to put it into action.…”

Section: Discussionmentioning

confidence: 99%

Social gradients and cumulative effects of income and education on dental health in the Fourth German Oral Health Study

Geyer

Schneller

Micheelis³

2010

Comm Dent Oral Epid

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Section: Discussionmentioning

confidence: 99%

Social gradients and cumulative effects of income and education on dental health in the Fourth German Oral Health Study

Geyer

Schneller

Micheelis³

2010

Comm Dent Oral Epid

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“…Earlier studies of the specific reform have abstracted from potentially heterogeneous treatment effects (Augurzky et al. ; Schreyögg and Grabka, ). Farbmacher and Winter () address measurement problems and nonlinearities that arise when using survey data to study the effects of a quarterly co‐payment, but restrict the analysis to homogeneous effects.…”

Section: Introductionmentioning

confidence: 99%

Heterogeneous Effects of a Nonlinear Price Schedule for Outpatient Care

et al. 2016

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Theoretical considerations suggest that nonlinear health care price schedules have heterogeneous effects on health care demand. In this paper, we develop and apply a finite mixture bivariate probit model to analyze whether there are heterogeneous reactions to the introduction of a nonlinear price schedule in the German statutory health insurance system. In administrative insurance claims data from the largest German health insurance plan, we find that some individuals strongly react to the new price schedule while a second group of individuals does not react. Post-estimation analyses reveal that the group of the individuals who do not react to the reform includes the relatively sick. These results are in line with forward-looking behavior: Individuals who are already sick expect that they will hit the kink in the price schedule and thus are less sensitive to the co-payment. Terms of use: Documents inJEL-Code: C350, I110, I180.Keywords: finite mixture models, bivariate probit, demand for health care, nonlinear price schedule.

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“…Van der Heyden et al (2003) approve the positive relation between income and specialist care utilization in Belgium based on the Belgian Health Interview Survey of 1997. In addition to this, it has been pointed out that low income groups tend to avoid or delay physician visits more often than high income groups (Burström 1990;Mielck et al 2009;Rückert et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Inequality in health care utilization in Germany? Theoretical and empirical evidence for specialist consultation

Gruber

Kiesel²

2010

J Public Health

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Aim In view of increasing concern about a two-class system in the German health care sector, this study investigates the relevance of health insurance schemes and other socioeconomic characteristics to the level of specialist health care provision. Subjects and Methods Referring to Ronald M. Andersen's model of health care utilization and more content-based approaches, we implement a negative binomial hurdle regression to estimate the number of specialist visits within the last 12 months. Our data source is the German sample of the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2004.Results The results show that men's number of specialist visits is markedly sensitive to predisposing and enabling factors, whereas women's health care utilization depends less on such socioeconomic characteristics. With reference to previous findings concerning general practitioner consultation, the assumption of a bipolar health care system providing general practitioner care primarily to the statutory insured and specialist care to the privately insured is supported empirically as to men. Education, which is considered to be highly correlated with health lifestyles, has a positive effect on medical health care. Every additional year of education increases by about 10% the probability of men seeking specialist consultation. Furthermore, the results indicate an unfavorable situation for the self-employed concerning health care because of their specific employment situation and health insurance coverage. Discussion The research results suggest the existence of relevant differences in the amount of specialist consultation according to health insurance and other socioeconomic features. Further research could concentrate on the question of whether these inequalities in utilization levels indicate overprovision or underprovision of ambulant health care. Moreover, we recommend longitudinal research that is particularly suited to detangle age and cohort effects.

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Are German patients burdened by the practice charge for physician visits ('Praxisgebuehr')? A cross sectional analysis of socio-economic and health related factors

Cited by 39 publications

References 17 publications

Social gradients and cumulative effects of income and education on dental health in the Fourth German Oral Health Study

Social gradients and cumulative effects of income and education on dental health in the Fourth German Oral Health Study

Heterogeneous Effects of a Nonlinear Price Schedule for Outpatient Care

Inequality in health care utilization in Germany? Theoretical and empirical evidence for specialist consultation

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