[Predictors for ambulatory medical care utilization in Germany]

An analysis of the possible influences on primary health care utilization is made. The theoretical framework is the health behavioural model of R. M. Andersen, dividing the influencing variables into the components predisposing characteristics, enabling resources, and need factors. The study was based on data from the German National Health Examination and Interview Survey of the adult population in 1998. The data were linked to regional structural data and aggregated account data. The total number of contacts, the number of contacts with general practitioners and internists, and the number of different specialists contacted in the last 12 months, as calculated from interview data, were used to indicate primary health care utilization. In addition to the expected strong influence of need factors such as morbidity and health-related quality of life, the predisposing characteristics such as region, urban/rural, age, and gender have a significant influence on the primary care utilization. With regard to the enabling factors, persons with a family doctor had more contacts overall, which contrasts with the family doctor's assumed gate-keeper function. From the results of the study, recommendations on possible regulatory measures are given, but also some restrictions for influencing the number of contacts are pointed out.