Evidence map›Paper›PMID 31202263›Full record

ArticleBMC family practice2019

Prevalence and predictors of having no general practitioner - analysis of the German health interview and examination survey for adults (DEGS1).

Judith Tillmann, Marie-Therese Puth, Klaus Weckbecker, Manuela Klaschik, Eva Münster

Abstract read
In one paragraph

Article in BMC family practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Judith TillmannInstitute of General Practice and Family Medicine, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
Marie-Therese PuthInstitute of General Practice and Family Medicine, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. puth@imbie.uni-bonn.de.ORCID 0000-0003-1351-9381
Klaus WeckbeckerInstitute of General Practice and Family Medicine, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
Manuela KlaschikInstitute of General Practice and Family Medicine, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
Eva MünsterInstitute of General Practice and Family Medicine, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough patients in Germany are generally free to choose their primary healthcare provider, this role should mainly be assumed by general practitioners (GPs). While some predictors of the frequency of use of GP services have been reported in international studies, there is still a lack in knowledge what could deter people from contacting a GP in Germany. To improve healthcare, it is important to identify characteristics of people without a GP.

methodsThis cross-sectional analysis was based on the first wave of the "German Health Interview and Examination Survey for Adults" (DEGS1) conducted by the Robert Koch Institute in 2008-2011. Descriptive analyses and multiple logistic regression by gender were performed to analyze the association between having no GP and age, gender, residential area, socioeconomic status (SES), marital status, working hours per week, general state of health, chronic diseases and health insurance.

resultsOverall, 9.5% (95% confidence interval (CI): 8.4-10.7) of the 7755 participants stated to have no GP, more often men (11.4%) than women (7.6%). Life in urban areas (big cities vs. rural: adjusted odds ratio (aOR): 2.9, 95% CI: 2.1-3.9), younger age (18-29 years vs. 65-79 years: aOR: 4.4, 95% CI: 2.5-7.7) and the presence of chronic diseases (yes vs. no: aOR: 0.4, 95% CI: 0.3-0.6) showed significant associations of not having a GP. For men, the type of health insurance (private vs. statutory: aOR: 2.1, 95% CI: 1.5-3.0; other vs. statutory: aOR: 2.1, 95% CI: 1.4-3.1) and for women, SES (low vs. medium: aOR: 1.8, 95% CI: 1.2-2.7; high vs. medium: aOR: 2.1, 95% CI: 1.4-3.0) increased the risk of having no GP.

conclusionsOur analysis offers new insights into the use of GPs in Germany and revealed differences between men and women. Public health strategies regarding access to a GP have to focus on men and on women with a low SES. Further analyses are needed to determine whether men with private health insurance prefer to consult a specialist rather than a GP. For young adults, improving the transition process from a pediatrician to a GP could fill a gap in health care.

Indexed as

Social ClassAdolescentAdultAgedAge FactorsChronic DiseaseCross-Sectional StudiesFacilities and Services UtilizationFemaleGeneral PracticeGermanyHealth SurveysHumansInsurance, HealthLogistic ModelsMaleDEGSFamily doctorGeneral practice utilizationGPHealthcareMedical carePublic health

Identifiers

PMID31202263
PMCPMC6570899

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.