ArticleBMC health services research2016
Overutilization of ambulatory medical care in the elderly German population?--An empirical study based on national insurance claims data and a review of foreign studies.
Article in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Pooled it
- Determinants of Frequent Attendance in Primary Care. A Systematic Review of Longitudinal Studies.Frontiers in medicine · 2021Pooled it
- Frequent attenders in late life in primary care: a systematic review of European studies.BMC family practice · 2017Pooled it
- Trial
- Regional differences in the patient population of general practices in northern Germany: results of a mixed-methods study.BMJ open · 2020Trial
- Characteristics of late HIV diagnosis in Germany in 2019 and 2020 - A regional analysis.Infection · 2026Article
- Perspectives of healthcare professionals on medical care in nursing homes in Germany and The Netherlands: an explorative study using qualitative content analysis.European journal of public health · 2025Article
- Translation and validation of the German version of the Nursing Brand Image Scale (NBIS-P-G).BMC nursing · 2025Article
- Potential Factors Associated with Healthcare Utilization for Balance Problems in Community-Dwelling Adults within the United States: A Narrative Review.Healthcare (Basel, Switzerland) · 2023Review
- Cost effectiveness and health-related quality of life of chemoradiotherapy versus radiation therapy alone in elderly head and neck cancer patients.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2022Article
- Interprofessional collaboration to support patients with social problems in general practice-a qualitative focus group study.BMC primary care · 2022Article
- Reducing Medication Problems among Minority Individuals with Low Socioeconomic Status through Pharmacist Home Visits.International journal of environmental research and public health · 2022Article
- Factors Contributing to Persistent Frequent Attendance in Primary Care Among the Oldest Old: Longitudinal Evidence From the AgeCoDe-AgeQualiDe Study.Frontiers in medicine · 2022Article
- The Impact of Pharmaceutical Home Care on Medical Utilization for Frequent Users of Outpatient Services in Taiwan.International journal of environmental research and public health · 2021Article
- Quality of care for people with multimorbidity: a focus group study with patients and their relatives.BMJ open · 2021Article
- Claims data analysis of medical specialist utilization among nursing home residents and community-dwelling older people.BMC health services research · 2020Article
- Determinants of Frequent Attendance in Primary Care. Study Protocol for a Systematic Review of Longitudinal Studies.International journal of environmental research and public health · 2020Article
- Differences in medical specialist utilization among older people in need of long-term care - results from German health claims data.International journal for equity in health · 2020Article
- Frequent attenders in the German healthcare system: determinants of high utilization of primary care services. Results from the cross-sectional German health interview and examination survey for adults (DEGS).BMC family practice · 2020Article
- Determinants of Frequent Attendance of Outpatient Physicians: A Longitudinal Analysis Using the German Socio-Economic Panel (GSOEP).International journal of environmental research and public health · 2019Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBy definition, high utilizers receive a large proportion of medical services and produce relatively high costs. The authors report the results of a study on the utilization of ambulatory medical care by the elderly population in Germany in comparison to other OECD countries. Evidence points to an excessive utilization in Germany. It is important to document these utilization figures and compare them to those in other countries since the healthcare system in Germany stopped recording ambulatory healthcare utilization figures in 2008.
methodsThe study is based on the claims data of all insurants aged ≥ 65 of a statutory health insurance company in Germany (n = 123,224). Utilization was analyzed by the number of contacts with physicians in ambulatory medical care and by the number of different practices contacted over one year. Criteria for frequent attendance were ≥ 50 contacts with practices or contacts with ≥ 10 different practices or ≥ 3 practices of the same discipline per year. Descriptive statistical analysis and logistic regression were applied. Morbidity was analyzed by prevalence and relative risk for frequent attendance for 46 chronic diseases.
resultsNineteen percent of the elderly were identified as high utilizers, corresponding to approximately 3.5 million elderly people in Germany. Two main types were identified. One type has many contacts with practices, belongs to the oldest age group, suffers from severe somatic diseases and multimorbidity, and/or is dependent on long-term care. The other type contacts large numbers of practices, consists of younger elderly who often suffer from psychiatric and/or psychosomatic complaints, and is less frequently multimorbid and/or nursing care dependent.
conclusionWe found a very high rate of frequent attendance among the German elderly, which is unique among the OECD countries. Further research should clarify its reasons and if this degree of utilization is beneficial for elderly people.
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