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Determinants of Frequent Attendance of Outpatient Physicians: A Longitudinal Analysis Using the German Socio-Economic Panel (GSOEP)

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  • Moritz Hadwiger

    (Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20246 Hamburg, Germany
    Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany)

  • Hans-Helmut König

    (Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20246 Hamburg, Germany)

  • André Hajek

    (Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20246 Hamburg, Germany)

Abstract

There is a lack of population-based longitudinal studies which investigates the factors leading to frequent attendance of outpatient physicians. Thus, the purpose of this study was to analyze the determinants of frequent attendance using a longitudinal approach. The used dataset comprises seven waves (2002 to 2014; n = 28,574 observations; ranging from 17 to 102 years) from the nationally representative German Socio-Economic Panel (GSOEP). The number of outpatient physician visits in the last three months was used to construct the dependent variable “frequent attendance”. Different cut-offs were used (top 25%; top 10%; top 5%). Variable selection was based on the “behavioral model of health care use” by Andersen. Accordingly, variables were grouped into predisposing, enabling, and need characteristics as well as health behavior, which are possible determinants of frequent attendance. Conditional fixed effects logistic regressions were used. As for predisposing characteristics, regressions showed that getting married and losing one’s job increased the likelihood of frequent attendance. Furthermore, age was negatively associated with the outcome measure. Enabling characteristics were not significantly associated with the outcome measure, except for the onset of the “practice fee”. Decreases in mental and physical health were associated with an increased likelihood of frequent attendance. Findings were robust across different subpopulations. The findings of this study showed that need characteristics are particularly important for the onset of frequent attendance. This might indicate that people begin to use health services frequently when medically indicated.

Suggested Citation

  • Moritz Hadwiger & Hans-Helmut König & André Hajek, 2019. "Determinants of Frequent Attendance of Outpatient Physicians: A Longitudinal Analysis Using the German Socio-Economic Panel (GSOEP)," IJERPH, MDPI, vol. 16(9), pages 1-10, May.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:9:p:1553-:d:227958
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    Cited by:

    1. André Hajek & Freia De Bock & Lothar H. Wieler & Philipp Sprengholz & Benedikt Kretzler & Hans-Helmut König, 2020. "Perceptions of Health Care Use in Germany during the COVID-19 Pandemic," IJERPH, MDPI, vol. 17(24), pages 1-13, December.
    2. André Hajek & Benedikt Kretzler & Hans-Helmut König, 2020. "Determinants of Frequent Attendance in Primary Care. Study Protocol for a Systematic Review of Longitudinal Studies," IJERPH, MDPI, vol. 17(10), pages 1-6, May.

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