Determinants of physician's office visits and potential effects of co‐payments: evidence from Austria

Hafner, Philipp; Mahlich, Jörg

doi:10.1002/hpm.2316

Cited by 15 publications

(17 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The analyses where focal predictors were alternatively removed from the model corroborate the interpretation that it is travel distance and not travel time that negatively affects visit frequency for the aggregated data of the six study regions. This corresponds to previous research findings as there were more non-significant results in studies addressing the effect of travel time [ 6 , 15 – 17 ] than in studies addressing the effect of travel distance [ 6 ]. However, once again, quality of communication has the by far largest effect.…”

Section: Discussionsupporting

confidence: 90%

“…Dummy-coded study regions were included to control for region-specific tendencies regarding provider visits. The status of diabetes and the five secondary complications of diabetes were included to control for the effect of health status because health status usually affects the number of health care provider visits [ 2 – 4 , 8 , 9 , 15 ]. The three socio-demographic variables (age, gender and education) were included because these variables are known to be related to health status [ 27 – 30 ] and thus might help to control for those aspects of health status that are not reflected by diabetes status and secondary complications.…”

Section: Methodsmentioning

confidence: 99%

“…Other studies have produced statistically significant negative associations of travel time with the tendency to visit an endocrinologist [ 8 ], the likelihood of visiting a physician [ 9 ], the likelihood of attending a hospital [ 9 ], the likelihood of in-facility delivery [ 10 ], the frequency of pre-natal care visits [ 10 , 11 ], and health-related quality of life [ 7 ]. However, there was no statistically significant association with the likelihood of visiting a general practitioner [ 15 , 16 ], the likelihood of visiting a gynaecologist [ 16 ], compliance to mammography [ 6 ] and the delay in seeking care in case of a malaria infection [ 17 ]. Further studies have produced statistically significant associations of in-practice waiting time with frequency of physician visits [ 18 ] and health-related quality of life [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The impact of accessibility and service quality on the frequency of patient visits to the primary diabetes care provider: results from a cross-sectional survey performed in six European countries

Konerding

Bowen²,

Elkhuizen

et al. 2020

BMC Health Serv Res

View full text Add to dashboard Cite

Background: Visits to the primary diabetes care provider play a central role in diabetes care. Therefore, patients should attend their primary diabetes care providers whenever a visit is necessary. Parameters that might affect whether this condition is fulfilled include accessibility (in terms of travel distance and travel time to the practice), as well as aspects of service quality (for example in-practice waiting time and quality of the provider's communication with the patient). The relationships of these variables with the frequency of visits to the primary diabetes care provider are investigated. Methods: The investigation is performed with questionnaire data of 1086 type 2 diabetes patients from study regions in England (213), Finland (135), Germany (218), Greece (153), the Netherlands (296) and Spain (71). Data were collected between October 2011 and March 2012. Data were analysed using log-linear Poisson regression models with self-reported numbers of visits in a year to the primary diabetes care provider as the criterion variable. Predictor variables of the core model were: country; gender; age; education; stage of diabetes; heart problems; previous stroke; problems with lower extremities; problems with sight; kidney problems; travel distance and travel time; in-practice waiting time; and quality of communication. To test region-specific characteristics, the interaction between the latter four predictor variables and study region was also investigated.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of accessibility and service quality on the frequency of patient visits to the primary diabetes care provider: results from a cross-sectional survey performed in six European countries

Konerding

Bowen²,

Elkhuizen

et al. 2020

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…12 However, the proportion of uncoordinated specialist contact rates increased remarkably. Similarly, evaluations in Austria 32 and Germany 33–35 showed that the introduction of a copayment had no significant influence on the number of physician contacts, while a systematic review, considering demand effects in different types of healthcare systems, identified reduced GP and specialist use due to copayments in the majority of the studies included. 36 In the context of the German copayment, €10 per quarter is a low barrier to ambulatory care.…”

Section: Discussionmentioning

confidence: 99%

Impact of the abolition of copayments on the GP-centred coordination of care in Bavaria, Germany: analysis of routinely collected claims data

et al. 2020

View full text Add to dashboard Cite

ObjectivesIn 2012, Germany abolished copayment for consultations in ambulatory care. This study investigated the effect of the abolition on general practitioner (GP)-centred coordination of care. We assessed how the proportion of patients with coordinated specialist care changed over time when copayment to all specialist services were removed. Furthermore, we studied how the number of ambulatory emergency cases and apparent ‘doctor shopping’ changed after the abolition.DesignA retrospective routine data analysis of the Bavarian Association of Statutory Health Insurance Physicians, comparing the years 2011 and 2012 (with copayment), with the period from 2013 to 2016 (without copayment). Therefore, time series analyses covering 24 quarters were performed.SettingPrimary care in Bavaria, Germany.ParticipantsAll statutorily insured patients in Bavaria, aged ≥18 years, with at least one ambulatory specialist contact between 2011 and 2016.Primary and secondary outcome measuresPrimary outcome was the percentage of patients with GP-coordinated care (every regular specialist consultation within a quarter was preceded by a GP referral). Secondary outcomes were the number of ambulatory emergency cases and apparent ‘doctor shopping’.ResultsAfter the abolition, the proportion of coordinated patients decreased from 49.6% (2011) to 15.5% (2016). Overall, younger patients and those living in areas with lower levels of deprivation showed the lowest proportions of coordination, which further decreased after abolition. Additionally, there were concomitant increases in the number of ambulatory emergency contacts and to a lesser extent in the number of patients with apparent ‘doctor shopping’.ConclusionsThe abolition of copayment in Germany was associated with a substantial decrease in GP coordination of specialist care. This suggests that the copayment was a partly effective tool to support coordinated care. Future studies are required to investigate how the gatekeeping function of GPs in Germany can best be strengthened while minimising the associated administrative overhead.

show abstract

“…Another proposed explanation is the finding in other literature that a large proportion of Japanese people aged between 50 and 70 years are lonely [ 32 ], particularly when compared with Western countries [ 33 ]. Visiting a physician’s office might be a strategy to cope with loneliness and a study has demonstrated a link between the desire to communicate with other patients in the waiting room and the number of office visits [ 34 ]. In line with this reasoning is the fact that Japan (and Korea) have by far the highest numbers of doctor’s office consultations among OECD countries [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Patient and Physician Preferences for Therapy Characteristics for Psoriasis: A Discrete Choice Experiment in Japan

Bolt

Kobayashi²,

Mahlich

2018

PharmacoEconomics Open

View full text Add to dashboard Cite

Background With progress being made in the treatment of psoriasis, a variety of clinical research and treatment options are being pursued. This study used a discrete choice experiment (DCE) to estimate treatment characteristic preferences for both patients and physicians in Japan. Subgroup analysis was also applied in order to examine differences within the range of patients and within the range of physicians. Methods The DCE was developed with the input of clinical experts in the treatment of psoriasis to ensure inclusion of the most relevant attributes at appropriate levels in a way that is understandable to both physicians and patients. The study was conducted on parallel samples of Japanese physicians ( n = 161) and Japanese psoriasis patients ( n = 306) through an online panel. For each sample, a conditional logit statistical model and subgroup analysis were then performed to estimate respondent preferences for treatment attributes. Results The overall findings are that better treatment efficacy as measured by proportion of patients achieving 90% reduction in the Psoriasis Area and Severity Index score (PASI 90), lower risk of adverse events and the availability of a bio-holiday are important decision factors for both patients and physicians. Low injection frequency is less of a priority for both samples. Also, while both groups demonstrate a preference to receive the treatment injections at a clinic by a healthcare professional rather than self-injection at home, this is more pronounced for the patient sample. The physician sample shows considerably more emphasis on the type of injection, though both samples prefer subcutaneous injections to intravenous injections. Implications This study reveals the importance of addressing both clinical effectiveness and process factors in systemic, non-topical psoriasis treatments to gain acceptance by both physicians and patients. As well as efficacy (as measured by PASI 90), which remains a consistent priority in treatment, administration and development of new treatments should also consider process factors such as the mode of administration and possibility for a bio-holiday. Electronic supplementary material The online version of this article (10.1007/s41669-018-0104-1) contains supplementary material, which is available to authorized users.

show abstract

Determinants of physician's office visits and potential effects of co‐payments: evidence from Austria

Cited by 15 publications

References 34 publications

The impact of accessibility and service quality on the frequency of patient visits to the primary diabetes care provider: results from a cross-sectional survey performed in six European countries

The impact of accessibility and service quality on the frequency of patient visits to the primary diabetes care provider: results from a cross-sectional survey performed in six European countries

Impact of the abolition of copayments on the GP-centred coordination of care in Bavaria, Germany: analysis of routinely collected claims data

Patient and Physician Preferences for Therapy Characteristics for Psoriasis: A Discrete Choice Experiment in Japan

Contact Info

Product

Resources

About