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[Predictors for ambulatory medical care utilization in Germany]
N Thode1, E Bergmann, P Kamtsiuris
1Charité, Berlin.
Summary
Predisposing characteristics like age and gender significantly influence primary health care use. However, enabling factors, such as having a family doctor, led to more overall contacts, challenging the gatekeeper role.
Area of Science:
- Health Services Research
- Public Health
- Health Economics
Background:
- Understanding primary health care utilization is crucial for resource allocation and policy development.
- The health behavioral model provides a framework for analyzing factors influencing healthcare seeking behavior.
- Previous research has identified various determinants of healthcare utilization, but specific influences on primary care in Germany require further investigation.
Purpose of the Study:
- To analyze the predisposing characteristics, enabling resources, and need factors influencing primary health care utilization in Germany.
- To examine the relationship between having a family doctor and the overall number of primary care contacts.
- To provide evidence-based recommendations for regulatory measures to optimize primary care access and utilization.
Main Methods:
- Utilized data from the German National Health Examination and Interview Survey (1998) for the adult population.
- Linked survey data with regional structural and aggregated account data for comprehensive analysis.
- Measured primary health care utilization through total contacts, contacts with general practitioners/internists, and specialist visits within 12 months.
Main Results:
- Need factors (morbidity, quality of life) strongly influenced primary care utilization, as expected.
- Predisposing characteristics (region, urban/rural, age, gender) also significantly impacted primary care use.
- Individuals with a family doctor reported higher overall contact numbers, contradicting the assumed gatekeeper role.
Conclusions:
- Primary health care utilization is multifactorial, influenced by individual characteristics, health status, and healthcare system structures.
- The findings suggest a need for policy adjustments regarding the role of family doctors in primary care.
- While some factors can be influenced by regulation, others present inherent restrictions on modifying contact numbers.