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Effect of type of insurance and income on waiting time for outpatient care

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  • Roll, Kathrin
  • Stargardt, Tom
  • Schreyögg, Jonas

Abstract

This paper analyzes the impact of type of insurance, income, and reason for appointment on waiting time for an appointment and waiting time in the physician's practice in the outpatient sector. Data were obtained from a German patient survey conducted between 2007 and 2009. We differentiated between GP and specialist and controlled for socioeconomic, structural, and institutional characteristics as well as interactions between type of insurance and control variables. Our results reveal that private health insurance plays a significant role in faster access to care at GP and specialist practices. Access to care is also highly influenced by the reason for an appointment. We also found that increased income had a negative effect on waiting time in practices and on waiting time for an appointment in GP practices. Whether inequalities in access to health care also impact overall quality of treatment needs to be investigated in future research.

Suggested Citation

  • Roll, Kathrin & Stargardt, Tom & Schreyögg, Jonas, 2011. "Effect of type of insurance and income on waiting time for outpatient care," hche Research Papers 2011/03, University of Hamburg, Hamburg Center for Health Economics (hche).
  • Handle: RePEc:zbw:hcherp:201103
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    1. Barzel, Yoram, 1974. "A Theory of Rationing by Waiting," Journal of Law and Economics, University of Chicago Press, vol. 17(1), pages 73-95, April.
    2. Kifmann, Mathias & Roeder, Kerstin, 2011. "Premium subsidies and social health insurance: Substitutes or complements?," Journal of Health Economics, Elsevier, vol. 30(6), pages 1207-1218.
    3. Oliver Tiemann & Jonas Schreyögg, 2012. "Changes in hospital efficiency after privatization," Health Care Management Science, Springer, vol. 15(4), pages 310-326, December.
    4. Kifmann, Mathias & Roeder, Kerstin, 2011. "Premium subsidies and social insurance: Substitutes or complements?," hche Research Papers 2011/01, University of Hamburg, Hamburg Center for Health Economics (hche).
    5. Schoen, Cathy & Doty, Michelle M., 2004. "Inequities in access to medical care in five countries: findings from the 2001 Commonwealth Fund International Health Policy Survey," Health Policy, Elsevier, vol. 67(3), pages 309-322, March.
    6. Sofia Dimakou & David Parkin & Nancy Devlin & John Appleby, 2009. "Identifying the impact of government targets on waiting times in the NHS," Health Care Management Science, Springer, vol. 12(1), pages 1-10, March.
    7. Walendzik, Anke & Greß, Stefan & Manouguian, Maral & Wasem, Jürgen, 2008. "Vergütungsunterschiede im ärztlichen Bereich zwischen PKV und GKV auf Basis des standardisierten Leistungsniveaus der GKV und Modelle der Vergütungsangleichung," IBES Diskussionsbeiträge 165, University of Duisburg-Essen, Institute of Business and Economic Studie (IBES).
    8. Sudano, Joseph J. & Baker, David W., 2006. "Explaining US racial/ethnic disparities in health declines and mortality in late middle age: The roles of socioeconomic status, health behaviors, and health insurance," Social Science & Medicine, Elsevier, vol. 62(4), pages 909-922, February.
    9. Luigi Siciliani & Jeremy Hurst, 2003. "Explaining Waiting Times Variations for Elective Surgery Across OECD Countries," OECD Health Working Papers 7, OECD Publishing.
    10. Gravelle, Hugh & Siciliani, Luigi, 2008. "Optimal quality, waits and charges in health insurance," Journal of Health Economics, Elsevier, vol. 27(3), pages 663-674, May.
    11. Jonas Schreyögg & Tom Stargardt & Oliver Tiemann & Reinhard Busse, 2006. "Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries," Health Care Management Science, Springer, vol. 9(3), pages 215-223, August.
    12. Kathrin Roll & Tom Stargardt & Jonas Schreyögg, 2012. "Effect of Type of Insurance and Income on Waiting Time for Outpatient Care," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 37(4), pages 609-632, October.
    13. Friedrich Breyer, 2004. "How to Finance Social Health Insurance: Issues in the German Reform Debate," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 29(4), pages 679-688, October.
    14. Bishai, David M. & Lang, Hui Chu, 2000. "The willingness to pay for wait reduction: the disutility of queues for cataract surgery in Canada, Denmark, and Spain," Journal of Health Economics, Elsevier, vol. 19(2), pages 219-230, March.
    15. Luigi Siciliani & Rossella Verzulli, 2009. "Waiting times and socioeconomic status among elderly Europeans: evidence from SHARE," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1295-1306, November.
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    Cited by:

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    2. Christian Bührer & Stefan Fetzer & Christian Hagist, 2018. "Adverse Selection in the German Health Insurance System – The Case of Civil Servants," WHU Working Paper Series - Economics Group 18-06, WHU - Otto Beisheim School of Management.
    3. Werbeck, Anna & Wübker, Ansgar & Ziebarth, Nicolas R., 2021. "Cream skimming by health care providers and inequality in health care access: Evidence from a randomized field experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 188(C), pages 1325-1350.
    4. Heinrich Nils & Wübker Ansgar & Wuckel Christiane, 2018. "Waiting Times for Outpatient Treatment in Germany: New Experimental Evidence from Primary Data," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 238(5), pages 375-394, September.
    5. Christian Bührer & Steffen Fetzer & Christian Hagist, 2017. "Cui bono? - Die Bürgerversicherung und die Beihilfe," WHU Working Paper Series - Economics Group 17-05, WHU - Otto Beisheim School of Management.
    6. Milstein, Ricarda & Schreyögg, Jonas, 2022. "Activity-based funding based on diagnosis-related groups: The end of an era? A review of payment reforms in the inpatient sector in ten high-income countries," hche Research Papers 28, University of Hamburg, Hamburg Center for Health Economics (hche).
    7. Schmitz, Hendrik, 2013. "Practice budgets and the patient mix of physicians – The effect of a remuneration system reform on health care utilisation," Journal of Health Economics, Elsevier, vol. 32(6), pages 1240-1249.
    8. Martin, Steve & Siciliani, Luigi & Smith, Peter, 2020. "Socioeconomic inequalities in waiting times for primary care across ten OECD countries," Social Science & Medicine, Elsevier, vol. 263(C).
    9. Kathrin Roll & Tom Stargardt & Jonas Schreyögg, 2012. "Effect of Type of Insurance and Income on Waiting Time for Outpatient Care," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 37(4), pages 609-632, October.
    10. Mingming Xu & Benjamin Bittschi, 2022. "Does the abolition of copayment increase ambulatory care utilization?: a quasi-experimental study in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(8), pages 1319-1328, November.
    11. Blankart, Carl Rudolf, 2012. "Does healthcare infrastructure have an impact on delay in diagnosis and survival?," Health Policy, Elsevier, vol. 105(2), pages 128-137.
    12. Bührer, Christian & Fetzer, Stefan & Hagist, Christian, 2020. "Adverse selection in the German Health Insurance System – the case of civil servants," Health Policy, Elsevier, vol. 124(8), pages 888-894.
    13. Christian Bührer & Steffen Fetzer & Christian Hagist, 2017. "Das Hamburger Beihilfemodell - Ein Vergleich der internen Renditen von GKV und PKV," WHU Working Paper Series - Economics Group 17-06, WHU - Otto Beisheim School of Management.
    14. Emmert, Martin & Meier, Florian & Heider, Ann-Kathrin & Dürr, Christoph & Sander, Uwe, 2014. "What do patients say about their physicians? An analysis of 3000 narrative comments posted on a German physician rating website," Health Policy, Elsevier, vol. 118(1), pages 66-73.
    15. Kifmann, Mathias, 2017. "Competition policy for health care provision in Germany," Health Policy, Elsevier, vol. 121(2), pages 119-125.
    16. Lindsey Woodworth, 2014. "The doctor will be with you ... shortly?," Journal of Regulatory Economics, Springer, vol. 45(2), pages 138-174, April.
    17. Diana Weidlich & Fredrik L. Andersson & Matthias Oelke & Marcus John Drake & Aino Fianu Jonasson & Julian F. Guest, 2017. "Annual direct and indirect costs attributable to nocturia in Germany, Sweden, and the UK," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(6), pages 761-771, July.

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