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Effect of Type of Insurance and Income on Waiting Time for Outpatient Care

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  • Kathrin Roll

    (1] Hamburg Center for Health Economics, Department for Health Care Management and Health Economics University of Hamburg, Hamburg, Germany.[2] Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.)

  • Tom Stargardt

    (1] Hamburg Center for Health Economics, Department for Health Care Management and Health Economics University of Hamburg, Hamburg, Germany.[2] Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.)

  • Jonas Schreyögg

    (1] Hamburg Center for Health Economics, Department for Health Care Management and Health Economics University of Hamburg, Hamburg, Germany.[2] Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.[3] Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, CA, USA.)

Abstract

This paper analyses the impact of type of insurance, income and reason for appointment on waiting time for an appointment and waiting time in the physician's practice in the outpatient sector. Data was obtained from a German patient survey conducted between 2007 and 2009. We differentiated between general practitioner (GP) and specialist and controlled for socioeconomic, structural and institutional characteristics as well as interactions between type of insurance and control variables. Our results reveal that private health insurance plays a significant role in faster access to care at GP and specialist practices. Access to care is also highly influenced by the reason for an appointment. We also found that increased income had a negative effect on waiting time in practices and on waiting time for an appointment in GP practices. Whether inequalities in access to health care also impact overall quality of treatment needs to be investigated in future research.

Suggested Citation

  • Kathrin Roll & Tom Stargardt & Jonas Schreyögg, 2012. "Effect of Type of Insurance and Income on Waiting Time for Outpatient Care," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 37(4), pages 609-632, October.
    • Handle: RePEc:pal:gpprii:v:37:y:2012:i:4:p:609-632
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    Cited by:

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    2. Emmert, Martin & Meier, Florian & Heider, Ann-Kathrin & Dürr, Christoph & Sander, Uwe, 2014. "What do patients say about their physicians? An analysis of 3000 narrative comments posted on a German physician rating website," Health Policy, Elsevier, vol. 118(1), pages 66-73.
    3. Hofer, Florian & Birkner, Benjamin & Spindler, Martin, 2021. "Power of machine learning algorithms for predicting dropouts from a German telemonitoring program using standardized claims data," hche Research Papers 24, University of Hamburg, Hamburg Center for Health Economics (hche).
    4. Kifmann, Mathias, 2017. "Competition policy for health care provision in Germany," Health Policy, Elsevier, vol. 121(2), pages 119-125.
    5. Mingming Xu & Benjamin Bittschi, 2022. "Does the abolition of copayment increase ambulatory care utilization?: a quasi-experimental study in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(8), pages 1319-1328, November.
    6. Milstein, Ricarda & Schreyögg, Jonas, 2022. "Activity-based funding based on diagnosis-related groups: The end of an era? A review of payment reforms in the inpatient sector in ten high-income countries," hche Research Papers 28, University of Hamburg, Hamburg Center for Health Economics (hche).
    7. Blankart, Carl Rudolf, 2012. "Does healthcare infrastructure have an impact on delay in diagnosis and survival?," Health Policy, Elsevier, vol. 105(2), pages 128-137.
    8. Christian Bührer & Stefan Fetzer & Christian Hagist, 2018. "Adverse Selection in the German Health Insurance System – The Case of Civil Servants," WHU Working Paper Series - Economics Group 18-06, WHU - Otto Beisheim School of Management.
    9. Schmitz, Hendrik, 2013. "Practice budgets and the patient mix of physicians – The effect of a remuneration system reform on health care utilisation," Journal of Health Economics, Elsevier, vol. 32(6), pages 1240-1249.
    10. Heinrich Nils & Wübker Ansgar & Wuckel Christiane, 2018. "Waiting Times for Outpatient Treatment in Germany: New Experimental Evidence from Primary Data," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 238(5), pages 375-394, September.
    11. Martin, Steve & Siciliani, Luigi & Smith, Peter, 2020. "Socioeconomic inequalities in waiting times for primary care across ten OECD countries," Social Science & Medicine, Elsevier, vol. 263(C).
    12. Kathrin Roll & Tom Stargardt & Jonas Schreyögg, 2012. "Effect of Type of Insurance and Income on Waiting Time for Outpatient Care," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 37(4), pages 609-632, October.
    13. Bührer, Christian & Fetzer, Stefan & Hagist, Christian, 2020. "Adverse selection in the German Health Insurance System – the case of civil servants," Health Policy, Elsevier, vol. 124(8), pages 888-894.
    14. Christian Bührer & Steffen Fetzer & Christian Hagist, 2017. "Das Hamburger Beihilfemodell - Ein Vergleich der internen Renditen von GKV und PKV," WHU Working Paper Series - Economics Group 17-06, WHU - Otto Beisheim School of Management.
    15. Lindsey Woodworth, 2014. "The doctor will be with you ... shortly?," Journal of Regulatory Economics, Springer, vol. 45(2), pages 138-174, April.
    16. Diana Weidlich & Fredrik L. Andersson & Matthias Oelke & Marcus John Drake & Aino Fianu Jonasson & Julian F. Guest, 2017. "Annual direct and indirect costs attributable to nocturia in Germany, Sweden, and the UK," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(6), pages 761-771, July.
    17. Christian Bührer & Steffen Fetzer & Christian Hagist, 2017. "Cui bono? - Die Bürgerversicherung und die Beihilfe," WHU Working Paper Series - Economics Group 17-05, WHU - Otto Beisheim School of Management.

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