Determinants of having no general practitioner in Germany and the influence of a migration background: results of the German health interview and examination survey for adults (DEGS1)

Tillmann, Judith; Puth, Marie-Therese; Frank, Laura; Weckbecker, Klaus; Klaschik, Manuela; Münster, Eva

doi:10.1186/s12913-018-3571-2

Cited by 9 publications

(13 citation statements)

References 38 publications

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“…Although it is likely that the participants’ migration background may have an impact on having no GP, it could not be assessed in this study due to lack of data in the PUF. Research that took the migration background of participants into account was for example considered in [31].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of having no general practitioner - analysis of the German health interview and examination survey for adults (DEGS1)

et al. 2019

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Background Although patients in Germany are generally free to choose their primary healthcare provider, this role should mainly be assumed by general practitioners (GPs). While some predictors of the frequency of use of GP services have been reported in international studies, there is still a lack in knowledge what could deter people from contacting a GP in Germany. To improve healthcare, it is important to identify characteristics of people without a GP. Methods This cross-sectional analysis was based on the first wave of the “German Health Interview and Examination Survey for Adults” (DEGS1) conducted by the Robert Koch Institute in 2008–2011. Descriptive analyses and multiple logistic regression by gender were performed to analyze the association between having no GP and age, gender, residential area, socioeconomic status (SES), marital status, working hours per week, general state of health, chronic diseases and health insurance. Results Overall, 9.5% (95% confidence interval (CI): 8.4–10.7) of the 7755 participants stated to have no GP, more often men (11.4%) than women (7.6%). Life in urban areas (big cities vs. rural: adjusted odds ratio (aOR): 2.9, 95% CI: 2.1–3.9), younger age (18–29 years vs. 65–79 years: aOR: 4.4, 95% CI: 2.5–7.7) and the presence of chronic diseases (yes vs. no: aOR: 0.4, 95% CI: 0.3–0.6) showed significant associations of not having a GP. For men, the type of health insurance (private vs. statutory: aOR: 2.1, 95% CI: 1.5–3.0; other vs. statutory: aOR: 2.1, 95% CI: 1.4–3.1) and for women, SES (low vs. medium: aOR: 1.8, 95% CI: 1.2–2.7; high vs. medium: aOR: 2.1, 95% CI: 1.4–3.0) increased the risk of having no GP. Conclusions Our analysis offers new insights into the use of GPs in Germany and revealed differences between men and women. Public health strategies regarding access to a GP have to focus on men and on women with a low SES. Further analyses are needed to determine whether men with private health insurance prefer to consult a specialist rather than a GP. For young adults, improving the transition process from a pediatrician to a GP could fill a gap in health care. Electronic supplementary material The online version of this article (10.1186/s12875-019-0976-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of having no general practitioner - analysis of the German health interview and examination survey for adults (DEGS1)

et al. 2019

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“…A German study found that people from a migrant background were less likely to have a GP, one explanation being those with a migrant background had trouble understanding the German healthcare system, which was significantly different to what they had experienced before arriving in Germany. Not having a GP may increase the likelihood of using healthcare services inappropriately [3].…”

Section: Introductionmentioning

confidence: 99%

Understanding how Eastern European migrants use and experience UK health services: a systematic scoping review

Phung

Asghar

Matiti

et al. 2020

BMC Health Serv Res

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Background: The UK has experienced significant immigration from Eastern Europe following European Union (EU) expansion in 2004, which raises the importance of equity and equality for the recent immigrants. Previous research on ethnic health inequalities focused on established minority ethnic groups, whereas Eastern European migrants are a growing, but relatively under-researched group. We aimed to conduct a systematic scoping review of published literature on Eastern European migrants' use and experiences of UK health services. Methods: An initial search of nine databases produced 5997 relevant publications. Removing duplicates reduced the figure to 2198. Title and abstract screening left 73 publications. Full-text screening narrowed this down further to 10 articles, with three more from these publications to leave 13 included publications. We assessed publications for quality, extracted data and undertook a narrative synthesis.Results: The included publications most commonly studied sexual health and family planning services. For Eastern European migrants in the UK, the most commonly cited barriers to accessing and using healthcare were limited understanding of how the system worked and language difficulties. It was also common for migrants to return to their home country to a healthcare system they were familiar with, free from language barriers. Familial and social networks were valuable for patients with a limited command of English in the absence of suitable and available interpreting and translating services. Conclusions:To address limited understanding of the healthcare system and the English language, the NHS could produce information in all the Eastern European languages about how it operates. Adding nationality to the Electronic Patient Report Form (EPRF) may reveal the demand for interpretation and translation services. Eastern European migrants need to be encouraged to register with GPs to reduce A&E attendance for primary care conditions. Many of the issues raised will be relevant to other European countries since the long-term outcomes from Brexit are likely to influence the level of Eastern European and non-Eastern European migration across the continent, not just the UK.

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“…Another possible explanation for lower odds of health services among persons residing in Germany for less than 2 years could be that they are unfamiliar with the structures of the German health care system. The importance and function of general practitioners in the country of origin and country of residence may differ a lot [18]. In Syria, for example, health care services are almost exclusively provided in health care centers and public hospitals [65].…”

Section: Factors Associated With Primary and Specialist Health Care U...mentioning

confidence: 99%

“…A few studies have suggested a difference in the use of primary and specialist health care among people with and without a migration background in Germany [15][16][17][18]. People with a migration background use preventive and rehabilitative measures to a lesser extent [15,[19][20][21][22], for example, clinical examinations for early detection of various diseases [17,19,23,24].…”

Section: Introductionmentioning

confidence: 99%

Investigating associated factors of primary and specialist health care utilization among people with selected nationalities: results of a multilingual survey in two German federal states

Loer

Koschollek

Hövener

2022

BMC Health Serv Res

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Background Approximately every fourth person in Germany has a migration background. Health research on the use of primary and specialist health care in this group is still scarce. Few studies have suggested a difference in the use of primary and specialist health care among people with a migration background. Potential resources and barriers to health care access should be investigated as they are critical to health equity. This study investigates associated sociodemographic, migration-sensitive, and health-related factors of primary and specialist health care utilization among people with a migration background as defined by nationality. Methods Analyses are based on data from a feasibility study of the project “Improving Health Monitoring in Migrant Populations” (IMIRA), conducted by the Robert Koch Institute. The sample (n = 1055) included persons with Croatian, Polish, Romanian, Syrian, and Turkish nationalities living in the federal states of Berlin and Brandenburg, Germany. Descriptive and bivariate analyses as well as multiple binary logistic regression analyses were carried out to assess sociodemographic (sex, age, socioeconomic position), health-related (self-rated health), and migration-sensitive factors (duration of residence in Germany, residence status, German language proficiency) associated with the use of primary and specialist health care services in the past 12 months. Results Of the total study population, 79.62% visited a general practitioner and 59.53% a specialized physician in the past 12 months. Participants who were female sex, aged 65 and older, and with moderate/poor/very poor self-rated health had higher odds of visiting a general practitioner and a specialized physician, with the strongest impact from self-rated health. After controlling for sociodemographic and health-related factors, duration of residence in Germany and residence status were associated with primary but not with specialist health care utilization. Conclusions Our results suggest that migration-sensitive characteristics, such as duration of residence, should be considered in a differentiated manner in health services research to gain detailed insights into health care utilization and its potential barriers among the heterogenous group of people with a migration background. Further research needs to be done to evaluate how to get people into contact with a general practitioner.

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Determinants of having no general practitioner in Germany and the influence of a migration background: results of the German health interview and examination survey for adults (DEGS1)

Cited by 9 publications

References 38 publications

Prevalence and predictors of having no general practitioner - analysis of the German health interview and examination survey for adults (DEGS1)

Prevalence and predictors of having no general practitioner - analysis of the German health interview and examination survey for adults (DEGS1)

Understanding how Eastern European migrants use and experience UK health services: a systematic scoping review

Investigating associated factors of primary and specialist health care utilization among people with selected nationalities: results of a multilingual survey in two German federal states

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