Goetjes, Eva; Blankart, Katharina (2024). Insurance barriers and inequalities in health care access: evidence from dual practice Health Economics Review, 14(1) BioMed Central 10.1186/s13561-024-00500-y
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Background We investigate access disparities in pharmaceutical care among German patients with type 2 diabetes, focusing on differences between public and private health insurance schemes. The primary objectives include investigating whether patients with private health insurance experience enhanced access to antidiabetic care and analyzing whether the treatment received by public and private patients is influenced by the practice composition, particularly the proportion of private patients. Methods We estimate fixed effect regression models, to isolate the effect of insurance schemes on treatment choices. We utilize data from a prescriber panel comprising 681 physicians collectively serving 68,362 patients undergoing antidiabetic treatments. Results The analysis reveals a significant effect of the patient's insurance status on antidiabetic care access. Patients covered by private insurance show a 10-percentage-point higher likelihood of receiving less complex treatments compared to those with public insurance. Furthermore, the composition of physicians' practices plays a crucial role in determining the likelihood of patients receiving less complex treatments. Notably, the most pronounced disparities in access are observed in practices mirroring the regional average composition. Conclusions Our findings underscore strategic physician navigation across diverse health insurance schemes in ambulatory care settings, impacting patient access to innovative treatments.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
School of Health Professions School of Health Professions > Institute of Health Economics and Health Policy |
Name: |
Goetjes, Eva and Blankart, Katharina |
Subjects: |
H Social Sciences > H Social Sciences (General) H Social Sciences > HA Statistics R Medicine > R Medicine (General) |
ISSN: |
2191-1991 |
Publisher: |
BioMed Central |
Language: |
English |
Submitter: |
Katharina Blankart |
Date Deposited: |
18 Apr 2024 08:23 |
Last Modified: |
21 Apr 2024 01:40 |
Publisher DOI: |
10.1186/s13561-024-00500-y |
Uncontrolled Keywords: |
Physician treatment style, Health insurance, Practice composition, Equity of care |
ARBOR DOI: |
10.24451/arbor.21761 |
URI: |
https://arbor.bfh.ch/id/eprint/21761 |
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