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Socioeconomic position and health services use in Germany and Spain during the Great Recession

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  • Lourdes Lostao
  • Siegfried Geyer
  • Romana Albaladejo
  • Almudena Moreno-Lostao
  • Juana M Santos
  • Enrique Regidor

Abstract

Objective: The relationship of socioeconomic position with the use of health services may have changed with the emergence of the economic crisis. This study shows that relationship before and during the economic crisis, in Germany and in Spain. Methods: Data from the 2006 and 2011 Socio-Economic Panel carried out in Germany, and from the 2006 and 2011 National Health Surveys carried out in Spain were used. The health services investigated were physician consultations and hospitalization. The measures of socioeconomic position used were education and household income. The magnitude of the relationship between socioeconomic position and the use of each health services was estimated by calculating the percentage ratio by binary regression. Results: In Germany, in both periods, after adjusting for age, sex, type of health insurance and need for care, subjects belonging to the lower educational categories had a lower frequency of physician consultations, while those belonging to the lower income categories had a higher frequency of hospitalization. In the model comparing the two lower socioeconomic categories to the two higher categories, the percentage ratio for physician consultation by education was 0.97 (95%CI 0.96–0.98) in 2006 and 0.96 (95%CI 0.95–0.97) in 2011, and the percentage ratio for hospitalization by income was 1.14 (95%CI 1.05–1.25) in 2006 and 1.12 (95%CI 1.03–1.21) in 2011. In Spain, no significant socioeconomic differences were observed in either period in the frequency of use of these health services in the fully adjusted model. Conclusion: The results suggest that the economic crisis did not alter accessibility to the health system in either country, given that the socioeconomic pattern in the use of these health services was similar before and during the crisis in both countries.

Suggested Citation

  • Lourdes Lostao & Siegfried Geyer & Romana Albaladejo & Almudena Moreno-Lostao & Juana M Santos & Enrique Regidor, 2017. "Socioeconomic position and health services use in Germany and Spain during the Great Recession," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-12, August.
    • Handle: RePEc:plo:pone00:0183325
    DOI: 10.1371/journal.pone.0183325
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    References listed on IDEAS

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    1. Eddy van Doorslaer & Cristina Masseria, 2004. "Income-Related Inequality in the Use of Medical Care in 21 OECD Countries," OECD Health Working Papers 14, OECD Publishing.
    2. Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
    3. Annamaria Lusardi & Daniel Schneider & Peter Tufano, 2015. "The Economic Crisis and Medical Care Use: Comparative Evidence from Five High-Income Countries," Social Science Quarterly, Southwestern Social Science Association, vol. 96(1), pages 202-213, March.
    4. Jens Hoebel & Petra Rattay & Franziska Prütz & Alexander Rommel & Thomas Lampert, 2016. "Socioeconomic Status and Use of Outpatient Medical Care: The Case of Germany," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-14, May.
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    Cited by:

    1. Domenica Matranga & Laura Maniscalco, 2022. "Inequality in Healthcare Utilization in Italy: How Important Are Barriers to Access?," IJERPH, MDPI, vol. 19(3), pages 1-14, February.
    2. Marc Saez & Maria Antònia Barceló & Carme Saurina & Andrés Cabrera & Antonio Daponte, 2019. "Evaluation of the Biases in the Studies that Assess the Effects of the Great Recession on Health. A Systematic Review," IJERPH, MDPI, vol. 16(14), pages 1-20, July.
    3. Jongsay Yong & Ou Yang, 2021. "Does socioeconomic status affect hospital utilization and health outcomes of chronic disease patients?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 329-339, March.

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