| Title |
Regional distribution of physicians: the role of comprehensive private health insurance in Germany
|
|---|---|
| Published in |
HEPAC Health Economics in Prevention and Care, April 2015
|
| DOI | 10.1007/s10198-015-0691-z |
| Pubmed ID | |
| Authors |
Leonie Sundmacher, Susanne Ozegowski |
| Abstract |
In recent years, the co-existence in Germany of two parallel comprehensive insurance systems-statutory health insurance (SHI) and private health insurance (PHI)-has been posited as a possible cause of a persistent unequal regional distribution of physicians. The present study investigates the effect of the proportion of privately insured patients on the density of SHI-licensed physicians, while controlling for regional variations in the average income from SHI patients. The proportion of residents in a district with private health insurance is estimated using complete administrative data from the SHI system and the German population census. Missing values are estimated using multiple imputation techniques. All models control for the estimated average income ambulatory physicians generate from treating SHI insured patients and a well-defined set of covariates on the level of districts in Germany in 2010. Our results show that every percentage change in the proportion of residents with private health insurance is associated with increases of 2.1 and 1.3 % in the density of specialists and GPs respectively. Higher SHI income in rural areas does not compensate for this effect. From a financial perspective, it is rational for a physician to locate a new practice in a district with a high proportion of privately insured patients. From the perspective of patients in the SHI system, the incentive effects of PHI presumably contribute to a concentration of health care services in wealthy and urban areas. To date, the needs-based planning mechanism has been unable to address this imbalance. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 47 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 11 | 23% |
| Researcher | 8 | 17% |
| Student > Doctoral Student | 5 | 11% |
| Student > Ph. D. Student | 4 | 9% |
| Other | 3 | 6% |
| Other | 7 | 15% |
| Unknown | 9 | 19% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 11 | 23% |
| Economics, Econometrics and Finance | 9 | 19% |
| Computer Science | 4 | 9% |
| Nursing and Health Professions | 4 | 9% |
| Business, Management and Accounting | 3 | 6% |
| Other | 4 | 9% |
| Unknown | 12 | 26% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 August 2019.
All research outputs
#7,356,343
of 25,374,647 outputs
Outputs from HEPAC Health Economics in Prevention and Care
#491
of 1,303 outputs
Outputs of similar age
#81,951
of 278,549 outputs
Outputs of similar age from HEPAC Health Economics in Prevention and Care
#8
of 23 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 1,303 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one has gotten more attention than average, scoring higher than 60% of its peers.
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We're also able to compare this research output to 23 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 60% of its contemporaries.