Forgone Care of doctor's visits in Germany – Results from three cross-sectional surveys

IF 3.6 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-02-18 DOI:10.1016/j.healthpol.2025.105273

Christine Haeger , Raphael Kohl , Julie L. O'Sullivan , Susanne Schnitzer

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引用次数: 0

Abstract

Background

Forgone care, defined as not using health care despite needing it, leads to adverse outcomes such as increased emergency care use. Our study uses data from German representative surveys (2016, 2021, 2022) to examine the frequency, demographics, and reasons for forgone care.

Methods

Multiple logistic regression models of individual cohorts and pooled data were used to assess the likelihood of forgoing a doctor's visit. Reasons for forgone care were analyzed descriptively and further clustered in different types of barriers.

Results

Of 10,122 participants, 21 % reported forgone care in the past year: 22 % in 2016, 18 % in 2021, and 20 % in 2022. The likelihood of forgone care is highest among women (OR: 1.22 [1.09; 1.37]) and younger adults aged 18–44 years (OR: 1.19 [1.05; 1.34]), whereas participants in partnerships were less likely to forgo care (OR: 0.77 [0.69; 0.87]). Barriers were categorized as systemic (e.g. waiting time; 39 %), psychological (e.g. fear of diagnosis; 22 %), and physical (e.g. difficulty reaching the doctor; 19 %). Younger adults and members of the workforce cited systemic barriers most often, whereas older adults (65+) cited psychological and physical barriers.

Discussion

Targeted interventions for vulnerable groups are needed that reduce barriers for forgone care. Recommendations include more accessible doctor's offices, improved appointment systems, expanded telemedicine, and flexible hours.

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放弃照顾医生在德国访问-从三个横断面调查的结果

放弃医疗保健的定义是，尽管需要医疗保健，但不使用医疗保健，这会导致诸如急诊护理使用增加等不良后果。我们的研究使用德国代表性调查（2016年、2021年、2022年）的数据来检查放弃护理的频率、人口统计数据和原因。方法采用个体队列和汇总数据的多元logistic回归模型评估放弃就诊的可能性。对放弃护理的原因进行描述性分析，并进一步聚类为不同类型的障碍。结果在10122名参与者中，21%的人报告在过去一年中放弃了护理：2016年为22%，2021年为18%，2022年为20%。放弃护理的可能性在女性中最高(OR: 1.22 [1.09；1.37])和18-44岁的年轻人(OR: 1.19 [1.05；1.34])，而伴侣关系的参与者不太可能放弃照顾(OR: 0.77 [0.69；0.87])。障碍分为系统性障碍(如等待时间；39%)，心理(如害怕诊断；22%)，以及身体上的(例如难以找到医生；19%)。年轻人和劳动力最常提到的是系统障碍，而老年人（65岁以上）则提到了心理和生理障碍。需要针对弱势群体的有针对性的干预措施，以减少放弃护理的障碍。建议包括更方便的医生办公室、改进预约系统、扩大远程医疗和灵活的工作时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.