Are German patients burdened by the practice charge for physician visits ('Praxisgebuehr')? A cross sectional analysis of socio-economic and health related factors
2008

Impact of Practice Charge on Physician Visits in Germany

Sample size: 7769 publication Evidence: moderate

Author Information

Author(s): Rückert Ina-Maria, Böcken Jan, Mielck Andreas

Primary Institution: Helmholtz Zentrum Muenchen – German Research Center for Environmental Health

Hypothesis

Patients who are socio-economically disadvantaged will delay or even avoid physician visits to a larger extent than patients with more favourable socio-economic backgrounds.

Conclusion

The study indicates that the practice charge affects health care utilization differently across socio-economic groups, potentially increasing health inequalities.

Supporting Evidence

  • 26.71% of participants delayed a physician visit due to the fee.
  • 18.02% avoided a physician visit altogether.
  • Those in the lowest income group reported delaying or avoiding visits 2.45 times more often than those in the highest income group.

Takeaway

Younger and poorer people are more likely to skip doctor visits because of a new fee in Germany.

Methodology

The study analyzed data from six representative surveys of the Bertelsmann Healthcare Monitor conducted between 2004 and 2006, focusing on responses from 7,769 adults aged 18 to 79.

Potential Biases

The study may not fully account for other factors influencing patients' decisions to seek medical care.

Limitations

The study could not assess if a person was exempt from the physician fee during the survey period, and the need to see a physician was only assessed in a crude way.

Participant Demographics

Participants were aged 18 to 79, with a mix of genders and socio-economic backgrounds, including those with and without chronic diseases.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI: 1.90–3.15

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1472-6963-8-232

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