Socioeconomic Status and the Utilization of Health Services in Germany: A Systematic Review

Klein, Jens; Hofreuter-Gätgens, Kerstin; Knesebeck, Olaf von dem

doi:10.1007/978-1-4614-9191-0_8

Cited by 56 publications

(41 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results con rm previous ndings. Persons living in poor socio-economic circumstances are hard to reach for health promotion and prevention services [1][2][3][4][5]. This is also the case for socio-economically deprived families when it comes to services and offers specialized in family-based addiction prevention [6,16,[35][36][37].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Limited access to family-based addiction prevention services for socio-economically deprived families in Switzerland: a grounded theory study

Pfister

Koschmieder

Wyss

2020

Preprint

View full text Add to dashboard Cite

Background: Families living in poor socio-economic circumstances, already confronted with social and health inequalities, are often not reached by family-based addiction prevention services. Besides quantitative models and health literacy approaches, qualitative research is lacking that could shed light on the exact circumstances and processes that lead to hindered addiction prevention service uptake by these families. Drawing on the concept of candidacy, we therefore reconstructed how socio-economically deprived parents and their (pre)adolescent children in the German-speaking part of Switzerland (non-)identified their candidacy for family-based addiction prevention services.Methods: Following grounded theory, we collected and analysed data in an iterative-cyclical manner using theoretical sampling and theoretical coding techniques. Sixteen families with children aged 10–14 years were interviewed in depth (parent/s and child separately). All but one family lived below the at-risk-of-poverty threshold.Results: Socio-economically deprived families’ modes of recognizing and handling problems in everyday life were found to be core phenomena that structure the process towards (non)identification of candidacy for family-based addiction prevention services. Four modes anchored within socio-demographic resources were found: Families with mode A perceived their current life situation as existentially-threatening and focused daily coping on the main pressing problem. Others (mode B) perceived prevalent multiple problems as normal (now); problems were normalized, often not recognized as such. In mode C families, problems were pragmatically recognized at a low threshold and pragmatically dealt with, mostly within the family. In mode D families, problems were constantly produced and dealt with early by the worried and anxious parents monitoring their child. From modes D to A, vulnerability increased concerning non-identification of candidacy for family-based addiction prevention services. Further, thematic relevance of addiction prevention, past experience with offers, integration in systems of assistance, strategies to protect the family, and families’ search for information influenced whether identification of candidacy took place.Conclusions: Socio-economically deprived families differ in modes of problem construction and handling in everyday life; this differently opens up or closes routes to family-based addiction prevention. Addiction prevention practice should build on a bundle of diverse strategies for outreach to these families, stressing especially interventions on the structural and environmental level.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Vulnerable populations most in need are often the least reached by health promotion and prevention services [1][2][3][4][5]. This is also the case when it comes to involving socio-economically deprived families with (pre)adolescent children in family-based substance abuse prevention programmes ( [6], p. 8).…”

Section: Introductionmentioning

confidence: 99%

Limited access to family-based addiction prevention services for socio-economically deprived families in Switzerland: a grounded theory study

Pfister

Koschmieder

Wyss

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Im Hinblick auf das Kriterium der Gerechtigkeit hat sich wiederholt gezeigt, dass bevölkerungsweite Aufklärungs-und Schulungsprogramme wie auch andere Interventionen, die auf das individuelle Verhalten zielen, eher zu einer Ausweitung als zu einer Reduktion von gesundheitlichen Ungleichheiten beitragen (Lorenc et al 2013). Auch werden Früherkennungsuntersuchungen von Menschen mit einem niedrigen sozialen Status seltener in Anspruch genommen (Klein et al 2014). Insofern ist auch bei Präventionsmaßnahmen in der Notfallmedizin verstärkt auf das Kriterium der Gerechtigkeit zu achten, z.B.…”

Section: Ethische Aspekte In Der Präventionunclassified

Ethik der Prävention am Beispiel von Notfällen

Vonneilich¹,

Knesebeck²

2015

Praxisbuch Ethik in Der Notfallmedizin: Orientierungshilfen Für Kritische Entscheidungen

Self Cite

View full text Add to dashboard Cite

Prävention in der Notfallmedizin erscheint als ein wichtiges Handlungsfeld, insbesondere bei genauerer Betrachtung der Häufigkeitsverteilung und Risikofaktoren von medizinischen Notfällen. Präventive Maßnahmen in der Notfallmedizin können einen Beitrag zur Senkung von lebensbedrohlichen Komplikationen und Mortalitätsrisiken leisten, beispielsweise durch Aufklärungs-und Schulungsprogramme oder durch Früherkennung. Bei der Entwicklung und Umsetzung solcher Maßnahmen sollten ethische Kriterien wie Beurteilung des Nutzen-und Schadenspotenzials, Respekt der Autonomie, Gerechtigkeit, Effizienz und Legitimität berücksichtigt werden.

show abstract

“…Für Deutschland zeigen verschiedene Studien, dass sozioökonomische Unterschiede zu Lasten von gesetzlich Versicherten und unteren sozialen Statusgruppen hauptsächlich in der Inanspruchnahme (z. B. von Präventionsmaßnahmen und Fachärzten) bestehen [4,5]. Gemäß dem Modell von Andersen wird die Inanspruchnahme der Gesundheitsversorgung von prädisponierenden (z.…”

Section: Introductionunclassified

“…Die Meinung der Patienten entspricht demnach zum Großteil den empirischen Studien, die für Deutschland Versorgungungleichheiten nachweisen konnten [4,16]. Als Dimensionen von Versorgungsungleichheiten nannten die Befragten verstärkt ermöglichende Faktoren und weniger prädisponierende Faktoren oder den Bedarf.…”

Section: Introductionunclassified

„Das liegt an jedem selbst“ - Eine qualitative Studie zu Versorgungsungleichheiten aus Patientensicht

et al. 2017

View full text Add to dashboard Cite

The aim of this qualitative study was to explore inequalities in healthcare from the patient's perspective. 44 semi-structured interviews with patients, aged 59-80 years, were conducted at the university hospital in Halle, Germany in 2014 and 2015. We analyzed the narratives following inductive qualitative content analysis. Most of the patients (82%) perceived inequalities in healthcare. Dimensions of healthcare inequalities from the patient's perspective were regional differences, type of health insurance, quality of physicians and the patients themselves (Income, Age). The patient's engagement in utilization was mentioned most often as a dimension of inequalities, but not considered a disadvantage. From the patient's perspective, inequalities were more prevalent in the outpatient sector (waiting time, lack of time). Economization in the healthcare system was viewed as the main reason of healthcare inequalities. We found no differences between patients of high and low socioeconomic status. From the patient´s point of view, their own capacity to orient and engage themselves in the healthcare system, as well as reduction of barriers to accessing outpatient care are highly important for reducing inequalities in healthcare.

show abstract

Socioeconomic Status and the Utilization of Health Services in Germany: A Systematic Review

Cited by 56 publications

References 66 publications

Limited access to family-based addiction prevention services for socio-economically deprived families in Switzerland: a grounded theory study

Limited access to family-based addiction prevention services for socio-economically deprived families in Switzerland: a grounded theory study

Ethik der Prävention am Beispiel von Notfällen

„Das liegt an jedem selbst“ - Eine qualitative Studie zu Versorgungsungleichheiten aus Patientensicht

Contact Info

Product

Resources

About