The influence of insurance status on waiting times in German acute care hospitals: an empirical analysis of new data

Kuchinke, Björn A.; Sauerland, Dirk; Wübker, Ansgar

doi:10.1186/1475-9276-8-44

Cited by 18 publications

(19 citation statements)

References 13 publications

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“…In Deutschland wurde bisher jedoch kaum untersucht, ob neben dieser Statuszugehörigkeit auch die Zugehörigkeit zu einer Gesetzlichen (GKV) beziehungsweise Privaten Krankenversicherung (PKV) einen bedeutsamen Einfluss auf den Zugang zur gesundheitlichen Versorgung und auf den Gesundheitszustand hat. Die diesbezüglich vorhandenen Forschungsergebnisse sind zudem sehr verstreut, und ein zusammenfassender Überblick über diese Arbeiten liegt bisher noch nicht vor [7,8,9,10,11].…”

Section: Originalien Und üBersichtenunclassified

Morbidität und Gesundheitsversorgung bei GKV- und PKV-Versicherten

Huber

Mielck²

2010

Bundesgesundheitsbl.

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Most studies show that there are large differences between GKV-insured and PKV-insured, concerning health status as well as healthcare. However, due to methodological weaknesses, some of these results are difficult to interpret. More studies focusing on specific age groups (e.g., children) are needed, and the methodological standard (e.g., statistical control for other factors such as income, distinction between different subgroups of insured) must also be raised. Finally, systematic differences between GKV and PKV should be considered in all analyses comparing these two schemes, such as differences in the availability of data concerning healthcare.

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Section: Originalien Und üBersichtenunclassified

Morbidität und Gesundheitsversorgung bei GKV- und PKV-Versicherten

Huber

Mielck²

2010

Bundesgesundheitsbl.

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“…Although helpful in getting a general sense of access, heterogeneity in wait times can be obscured. For example, studies have shown that privately insured patients have better access to physicians than publicly insured patients do (Kuchinke, Sauerland, & Wubker, 2009, found this to be the case in Germany for hospital admissions; Czypionka, Kraus, Riedel, & Rohrling, 2007, in Austria for elective surgery; MedPAC, 2017, in the United States for routine care). This is conceivably the rational choice given that private providers may be trying to maximize profit.…”

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confidence: 99%

Priority access to health care: Evidence from an exogenous policy shock

et al. 2020

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Access to care is an important issue in public health care systems. Unlike private systems, in which price equilibrates supply and demand, public systems often ration medical services through wait times. Access that is given on a first come, first served basis might not yield an allocation of resources that maximizes the health of a population, potentially creating suboptimal heterogeneity in wait times. In this study, we examine an access disparity between two groups of patients-established patients and new patients. We exploit an exogenous policy change-implemented by the U.S. Veterans Health Administration-that removed the disparity and homogenized the wait time.We find strong evidence that without such a policy, established patients have priority access over new patients. We discuss whether this is a suboptimal allocation of resources. We additionally find that established patient priority access is an important determinant of access for new patients; accounting for it increased the explanatory power of our statistical model of new patient wait times by a factor of five. The findings imply that policy and management decisions may be more effective in achieving the optimal distribution of access if access heterogeneity is recognized and accounted for explicitly. K E Y W O R D Saccess to care, prioritization, public health care, resource allocation, wait time

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“…Apparently, there is only little evidence for the existence of a so called two-tier medicine -at least with respect to our dataset. However, in contrast to Kuchinke, Sauerland & Wübker (2009), who analyzed whether hospitals discriminate patients in waiting times by their insurance status, we aim at a more competition policy related issue. That is, we analyze the impact of the degree of competition between hospitals on the probability that a hospital inquires a patients' insurance status.…”

Section: Datamentioning

confidence: 99%

Hospital Market Concentration and Discrimination of Patients

Dewenter¹,

Jaschinski²,

Kuchinke³

2013

Schmollers Jahrbuch

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. The working papers published in the Series constitute work in progress circulated to stimulate discussion and critical comments. Views expressed represent exclusively the authors' own opinions and do not necessarily reflect those of the editor. We are grateful to the participants of the 6 th DIBOGS 2010 and the 35 th Hohenheimer Oberseminar 2010. We also thank Ulrich Heimeshoff, Annika Herr and Hendrik Schmitz for most valuable comments; we are also grateful to Dr. med. Lüder Herzog for medical advisory. The usual disclaimer applies. Terms of use: Documents in 1 Hospital Market Concentration and Discrimination of Patients July 2012 AbstractIn this paper we investigate the existence of a two-tier medical system in the German acute care hospital sector using data from a survey of 483 German hospitals. The focus of our analysis lies on the impact of hospital concentration on the probability of discrimination of patients with different health insurances in regard to the access to medical services. Accounting for a possible endogeneity of market structure, we find that hospitals in highly concentrated markets are less likely to pursue any differentiation among prospective patients with different health insurances. We ascribe this finding to competitive pressure in less concentrated markets. Hospitals in competitive markets are more obliged to steal business from rival hospitals by privileging profitable patients than hospitals in highly concentrated markets.

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The influence of insurance status on waiting times in German acute care hospitals: an empirical analysis of new data

Cited by 18 publications

References 13 publications

Morbidität und Gesundheitsversorgung bei GKV- und PKV-Versicherten

Morbidität und Gesundheitsversorgung bei GKV- und PKV-Versicherten

Priority access to health care: Evidence from an exogenous policy shock

Hospital Market Concentration and Discrimination of Patients

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