Exploring the differences in general practitioner and health care specialist utilization according to education, occupation, income and social networks across Europe: findings from the European social survey (2014) special module on the social determinants of health

Fjær, Erlend Løvø; Balaj, Mirza; Stornes, Per; Todd, Adam; McNamara, Courtney L.; Eikemo, Terje Andreas

doi:10.1093/eurpub/ckw255

Cited by 50 publications

(41 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A medically unjustified preference of patients in big cities to visit specialists instead of GPs would be a misallocation. In contrast to results reported in most of the literature, not only participants with a low SES but also those with a high SES were less likely to have a GP, especially women [ 5 , 6 , 45 ]. Those with a high SES may again prefer to approach medical specialists.…”

Section: Discussioncontrasting

confidence: 85%

“…Better health outcomes through GP-centered healthcare in Germany, especially among older or chronically ill patients, have already been described [ 3 , 4 ]. International research has been limited to the frequency of use of GPs by the general population [ 5 – 8 ]. Yet it is important to initiate research earlier to find out what drives or deters people to have a GP or not.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Puth

Frank

et al. 2018

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundIt is aspired in the German healthcare system that general practitioners (GPs) act as initial contact for patients and guide through at all steps of medical treatment. This study aims at identifying factors associated with the odds of having no GP within the general population and especially among people with migration background.MethodsThis cross-sectional analysis was based on the “German Health Interview and Examination Survey for Adults” (DEGS1) conducted by the Robert Koch Institute. Descriptive analyses as well as multiple logistic regression models were performed to analyse the impact of a migration background, age, gender, residential area, socioeconomic status (SES) and other factors on having no GP among 7755 participants.Results9.5% of the total study population and 14.8% of people with a migration background had no GP, especially men, adults living in big cities and without chronic diseases. The odds of not having a GP were higher for people with a two-sided migration background (aOR: 1.90, 95% CI: 1.42–2.55). Among the population with a migration background, particularly young adults, men, people living in big cities and having a private health insurance showed higher odds to have no GP.ConclusionsIt is necessary to investigate the causes of the differing utilization of healthcare of people with a migration background and, if necessary, to take measures for an equal access to healthcare for all population groups. Further research needs to be done to evaluate how to get young people into contact with a GP.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3571-2) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussioncontrasting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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

Puth

Frank

et al. 2018

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Inequality in healthcare favouring the better off has been observed in many countries10–12 and healthcare insurance and eligibility for government healthcare based on income thresholds may influence the associations observed. NHS healthcare is not constrained by ability to pay and hence we were able to examine the independent association of residential area deprivation—material living conditions, poor quality housing and poor infrastructure—and its association with subsequent hospitalisation.…”

Section: Discussionmentioning

confidence: 94%

“…When measured over a period of time, the outcome represents burden of resources that might be attributable to a population. Inequality in healthcare utilisation favouring patients who are better off is apparent in half of the Organisation for Economic Co-operation and Development countries 10–12. The UK National Health Service is free at the point of use and consequently should provide equitable healthcare not constrained by ability to pay.…”

Section: Introductionmentioning

confidence: 99%

Residential area deprivation and risk of subsequent hospital admission in a British population: the EPIC-Norfolk cohort

et al. 2019

View full text Add to dashboard Cite

ObjectivesTo investigate whether residential area deprivation index predicts subsequent admissions to hospital and time spent in hospital independently of individual social class and lifestyle factors.DesignProspective population-based study.SettingThe European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) study.Participants11 214 men and 13 763 women in the general population, aged 40–79 years at recruitment (1993–1997), alive in 1999.Main outcome measureTotal admissions to hospital and time spent in hospital during a 19-year time period (1999–2018).ResultsCompared to those with residential Townsend Area Deprivation Index lower than the average for England and Wales, those with a higher than average deprivation index had a higher likelihood of spending >20 days in hospital multivariable adjusted OR 1.18 (95% CI 1.07 to 1.29) and having 7 or more admissions OR 1.11 (95% CI 1.02 to 1.22) after adjustment for age, sex, smoking status, education, social class and body mass index. Occupational social class and educational attainment modified the association between area deprivation and hospitalisation; those with manual social class and lower education level were at greater risk of hospitalisation when living in an area with higher deprivation index (p-interaction=0.025 and 0.020, respectively), while the risk for non-manual and more highly educated participants did not vary greatly by area of residence.ConclusionResidential area deprivation predicts future hospitalisations, time spent in hospital and number of admissions, independently of individual social class and education level and other behavioural factors. There are significant interactions such that residential area deprivation has greater impact in those with low education level or manual social class. Conversely, higher education level and social class mitigated the association of area deprivation with hospital usage.

show abstract

“…This category shows a structural representation of inequalities. When parents are living in adverse socioeconomic conditions, these have a direct impact on the health and development of their children, and on top of this, these problems at such a young age will have a negative effect in the long term both on their health and on their socioeconomic level 10. They tend indeed to be influenced by their parents’ socioeconomic conditions that become difficult to leave behind.…”

Section: Building Evidence-based Policies To Tackle Socioeconomic Heamentioning

confidence: 99%

Socioeconomic inequalities in health and the use of healthcare services in Catalonia: analysis of the individual data of 7.5 million residents

Casasnovas

2018

J Epidemiol Community Health

View full text Add to dashboard Cite

Exploring the differences in general practitioner and health care specialist utilization according to education, occupation, income and social networks across Europe: findings from the European social survey (2014) special module on the social determinants of health

Cited by 50 publications

References 22 publications

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)

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)

Residential area deprivation and risk of subsequent hospital admission in a British population: the EPIC-Norfolk cohort

Socioeconomic inequalities in health and the use of healthcare services in Catalonia: analysis of the individual data of 7.5 million residents

Contact Info

Product

Resources

About