Is There Migration-Related Inequity in Access to or in the Utilisation of Health Care in Germany?
This paper analyses immigrants' access to health care and utilisation of health care services in Germany. Thereby, it is investigated if there is inequity in access to or in the utilisation of health care services due to a lack of language skills or due to a lack of information about the health care system (approximated by years since migration)among first- and secondgeneration immigrants. The data used are drawn from eleven waves of the SOEP (1995-2006). With regard to the probability to contacta physician (as a proxy for access), German language skills are found to have no significant influence for all groups of immigrants. The hypothesis of inequity in access to health care due to access barriers caused by a lack of German language skills is therefore not supported by the data. However, mother tongue language skillsseem to be important for the contact probability of the first- and secondgeneration: Having only good or poor mother tongue language skills reduces the probability of a doctor contact. The effect is found to be significant for first- and second-generation men. For the frequency of doctor visits (utilisation), poor German language skills are found to exert a significant influence: Those reporting poor language skills have a lower expected number of doctor visits. The effect is found to be significant for first-generation men and for secondgeneration men and women. Hence, there seems to be inequity in health care utilisation due to a lack of German language skills. With the exception of first-generation men - where it is found that poor mother tongue language skills reduce the expected number of doctor visits significantly, no significant effect is found for mother tongue language skills. With regard to the duration of residence, the results indicate that years since migration have an impact on the contact decision of first-generation immigrant women, whereby a significant positive influence is found. Hence, missing knowledge about the health care system could create additional access barriers and yield inequity in access to health care in the group of firstgeneration women. The duration of residence seems to have no influence on the frequency decision.
|Date of creation:||2008|
|Contact details of provider:|| Postal: Mohrenstraße 58, D-10117 Berlin|
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- Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
- Ulf- G. Gerdtham, 1997.
"Equity in Health Care Utilization: Further Tests Based on Hurdle Models and Swedish Micro Data,"
John Wiley & Sons, Ltd., vol. 6(3), pages 303-319.
- Gerdtham, Ulf-G., 1996. "Equity in Health Care Utilisation: Further Tests Based on Hurdle models and Swedish Micro Data," SSE/EFI Working Paper Series in Economics and Finance 116, Stockholm School of Economics.
- O'Donnell, Owen & Propper, Carol, 1991. "Equity and the distribution of UK National Health Service resources," Journal of Health Economics, Elsevier, vol. 10(1), pages 1-19, May.
- O'Donnell, Owen & Propper, Carol, 1991. "Equity and the distribution of U.K. National Health Service resources," Journal of Health Economics, Elsevier, vol. 10(2), pages 247-249, July.
- Joseph Hilbe, 1994. "Negative binomial regression," Stata Technical Bulletin, StataCorp LP, vol. 3(18).
- Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
- Deri, Catherine, 2005. "Social networks and health service utilization," Journal of Health Economics, Elsevier, vol. 24(6), pages 1076-1107, November.
- Deb, Partha & Trivedi, Pravin K., 2002. "The structure of demand for health care: latent class versus two-part models," Journal of Health Economics, Elsevier, vol. 21(4), pages 601-625, July.
- Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
- Adam Wagstaff & Eddy van Doorslaer, 2000. "Measuring and Testing for Inequity in the Delivery of Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 35(4), pages 716-733.
- Gurmu, Shiferaw, 1997. "Semi-Parametric Estimation of Hurdle Regression Models with an Application to Medicaid Utilization," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 225-243, May-June.
- Mullahy, John, 1986. "Specification and testing of some modified count data models," Journal of Econometrics, Elsevier, vol. 33(3), pages 341-365, December.
- van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
- Deb, Partha & Trivedi, Pravin K, 1997. "Demand for Medical Care by the Elderly: A Finite Mixture Approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 313-336, May-June.
- Matthew Sutton, 2002. "Vertical and horizontal aspects of socio-economic inequity in general practitioner contacts in Scotland," Health Economics, John Wiley & Sons, Ltd., vol. 11(6), pages 537-549.
- Sergi Jiménez-Martín & José M. Labeaga & Maite Martínez-Granado, 2002. "Latent class versus two-part models in the demand for physician services across the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 301-321.
- Elke Holst & Dean R. Lillard & Thomas A. DiPrete, 2001. "Proceedings of the 2000 Fourth International Conference of German Socio-Economic Panel Study Users (GSOEP 2000): Editorial Introduction," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 70(1), pages 5-6.
- Barry R. Chiswick & Yew Liang Lee & Paul W. Miller, 2008. "Immigrant Selection Systems And Immigrant Health," Contemporary Economic Policy, Western Economic Association International, vol. 26(4), pages 555-578, October.
- Chiswick, Barry R. & Lee, Yew Liang & Miller, Paul W., 2006. "Immigrant Selection Systems and Immigrant Health," IZA Discussion Papers 2345, Institute for the Study of Labor (IZA).
- Teresa Bago d'Uva, 2005. "Latent class models for use of primary care: evidence from a British panel," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 873-892.
- Winfried Pohlmeier & Volker Ulrich, 1995. "An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 30(2), pages 339-361.
- Ulf-G. Gerdtham & Pravin K. Trivedi, 2001. "Equity in Swedish health care reconsidered: new results based on the finite mixture model," Health Economics, John Wiley & Sons, Ltd., vol. 10(6), pages 565-572.
- Gerdtham, Ulf-G. & Trivedi, Pravin K., 2000. "Equity in Swedish Health Care Reconsidered: New Results based on the Finite Mixture Model," SSE/EFI Working Paper Series in Economics and Finance 365, Stockholm School of Economics.
- Partha Deb & Ann M. Holmes, 2000. "Estimates of use and costs of behavioural health care: a comparison of standard and finite mixture models," Health Economics, John Wiley & Sons, Ltd., vol. 9(6), pages 475-489.
- Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "On the measurement of horizontal inequity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 169-205, July.
- Gert G. Wagner & Joachim R. Frick & Jürgen Schupp, 2007. "The German Socio-Economic Panel Study (SOEP) – Scope, Evolution and Enhancements," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 127(1), pages 139-169.
- Gert G. Wagner & Joachim R. Frick & Jürgen Schupp, 2007. "The German Socio-Economic Panel Study (SOEP): Scope, Evolution and Enhancements," SOEPpapers on Multidisciplinary Panel Data Research 1, DIW Berlin, The German Socio-Economic Panel (SOEP).
- Williams, Alan & Cookson, Richard, 2000. "Equity in health," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 35, pages 1863-1910 Elsevier.
- Moulton, Brent R, 1990. "An Illustration of a Pitfall in Estimating the Effects of Aggregate Variables on Micro Unit," The Review of Economics and Statistics, MIT Press, vol. 72(2), pages 334-338, May. Full references (including those not matched with items on IDEAS)
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