ArticleInternational journal for equity in health2018
Use of health services according to income before and after elimination of copayment in Germany and restriction of universal health coverage in Spain.
Article in International journal for equity in health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Evaluation of the Biases in the Studies that Assess the Effects of the Great Recession on Health. A Systematic Review.International journal of environmental research and public health · 2019Pooled it
- Cost-Sharing Effects on Hospital Service Utilization Among Older People in Fukuoka Prefecture, Japan.International journal of health policy and management · 2022Article
- Influence of Pharmaceutical Copayment on Emergency Hospital Admissions: A 1978-2018 Time Series Analysis in Spain.International journal of environmental research and public health · 2021Article
- Solidarity against healthcare access restrictions on undocumented immigrants in Spain: the REDER case study.International journal for equity in health · 2019Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundIn Germany copayment for medical consultation was eliminated in 2013, and in Spain universal health coverage was partly restricted in 2012. This study shows the relationship between income and the use of health services before and after these measures in each country.
methodsData were taken from the 2009 and 2014 Socio-Economic Panel conducted in Germany, and from the 2009 and 2014 European Health Surveys in Spain. The health services investigated were physician consultations and hospital admissions, and the measure of socioeconomic position used was household income. The magnitude of the relationship between socioeconomic position and the use of each health service in people from 16 to 74 years old was estimated by calculating the percentage ratio using binary regression.
resultsIn Germany, after adjusting for age, sex, and need for care, in the model comparing the two lower income categories to the two higher categories, the percentage ratio for physician consultation was 0.97 (95% CI 0.96-0.99) in 2009 and 0.98 (95% CI 0.97-0.99) in 2014, and the percentage ratio for hospitalization was 1.01 (95% CI 0.93-1.10) in 2009 and 1.16 (95% CI 1.08-1.25) in 2014. In Spain, after adjusting for age, sex, and self-rated health, the percentage ratio for physician consultation was 0.99 (95% CI 0.94-1.05) in 2009 and 1.08 (95% CI 1.03-1.14) in 2014, and the percentage ratio for hospitalization was 1.04 (95% CI 0.92-1.18) in 2009 and 0.99 (95% CI 0.87-1.14) in 2014.
conclusionThe results suggest that elimination of the copayment in Germany did not change the frequency of physician consultations, whereas after the restriction of universal health coverage in Spain, subjects with lower incomes had a higher frequency of physician consultations.
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