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Forgone care among chronically ill patients in Germany—Results from a cross-sectional survey with 15,565 individuals

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  • Röttger, Julia
  • Blümel, Miriam
  • Köppen, Julia
  • Busse, Reinhard

Abstract

The decision not to seek health care although one feels that care is needed (forgone care), is influenced by various factors. Within the study “Responsiveness in ambulatory care” 15,565 chronically ill (coronary heart disease and/or type 2 diabetes) patients in Germany were surveyed in 2013. The survey included questions on forgone care, perceived discrimination when seeking care, net-income, subjective health status and subjective socioeconomic status (subSES). Survey data were linked on patient-level with administrative claims data by a German sickness fund. We applied multivariate binomial logistic regression analyses to assess the association between age, sex, comorbidities, living area, subjective health status, subSES, experienced discrimination, net-equivalent income and reported forgone care. The majority in the sample are men (71.4%), the average age is 69.4 (SD: 10.2) years and 14.1% reported forgone care. In the multivariate model, we find that younger age, female gender, perceived discrimination, depression, and a poor subjective health status increase the odds of reporting forgone care. Overall, our results suggest that a negative experience with the health care system, i.e. perceived discrimination/unfair treatment, are strong predictors of forgone care among the chronically ill.

Suggested Citation

  • Röttger, Julia & Blümel, Miriam & Köppen, Julia & Busse, Reinhard, 2016. "Forgone care among chronically ill patients in Germany—Results from a cross-sectional survey with 15,565 individuals," Health Policy, Elsevier, vol. 120(2), pages 170-178.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:2:p:170-178
    DOI: 10.1016/j.healthpol.2016.01.004
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    Cited by:

    1. Carnazza, Giovanni & Liberati, Paolo & Resce, Giuliano, 2023. "Income-related unmet needs in the European countries," Socio-Economic Planning Sciences, Elsevier, vol. 87(PA).
    2. Carlota Quintal & Luis Moura Ramos & Micaela Antunes & Óscar Lourenço, 2023. "Unmet healthcare needs among the population aged 50+ and their association with health outcomes during the COVID-19 pandemic," European Journal of Ageing, Springer, vol. 20(1), pages 1-14, December.
    3. Yunhan Wang & Nan Jiang & Haiya Shao & Zhonghua Wang, 2024. "Exploring unmet healthcare needs and associated inequalities among middle-aged and older adults in Eastern China during the progression toward universal health coverage," Health Economics Review, Springer, vol. 14(1), pages 1-12, December.
    4. Natasa Popovic & Zorica Terzic-Supic & Snezana Simic & Biljana Mladenovic, 2017. "Predictors of unmet health care needs in Serbia; Analysis based on EU-SILC data," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-20, November.
    5. Perla Werner & Aviad Tur-Sinai & Hanan AboJabel, 2021. "Examining Dementia Family Caregivers’ Forgone Care for General Practitioners and Medical Specialists during a COVID-19 Lockdown," IJERPH, MDPI, vol. 18(7), pages 1-11, April.
    6. Röttger, Julia & Blümel, Miriam & Linder, Roland & Busse, Reinhard, 2017. "Health system responsiveness and chronic disease care – What is the role of disease management programs? An analysis based on cross-sectional survey and administrative claims data," Social Science & Medicine, Elsevier, vol. 185(C), pages 54-62.
    7. Veronika Kočiš Krůtilová & Lewe Bahnsen, 2021. "Cost-Induced Unmet Need for Health Care among Europe's Older Adults - The Role of Specific Diseases," European Journal of Business Science and Technology, Mendel University in Brno, Faculty of Business and Economics, vol. 7(2), pages 210-222.
    8. Ramos, Luís Moura & Quintal, Carlota & Lourenço, Óscar & Antunes, Micaela, 2019. "Unmet needs across Europe: Disclosing knowledge beyond the ordinary measure," Health Policy, Elsevier, vol. 123(12), pages 1155-1162.

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