Insurance barriers and inequalities in health care access: evidence from dual practice
Abstract 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...
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Format: | Article |
Language: | English |
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BMC
2024-03-01
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Series: | Health Economics Review |
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Online Access: | https://doi.org/10.1186/s13561-024-00500-y |
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author | Eva Goetjes Katharina E. Blankart |
author_facet | Eva Goetjes Katharina E. Blankart |
author_sort | Eva Goetjes |
collection | DOAJ |
description | Abstract 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. |
first_indexed | 2024-04-24T19:59:34Z |
format | Article |
id | doaj.art-c15beb80d1574ea48497ea120e60f388 |
institution | Directory Open Access Journal |
issn | 2191-1991 |
language | English |
last_indexed | 2024-04-24T19:59:34Z |
publishDate | 2024-03-01 |
publisher | BMC |
record_format | Article |
series | Health Economics Review |
spelling | doaj.art-c15beb80d1574ea48497ea120e60f3882024-03-24T12:10:16ZengBMCHealth Economics Review2191-19912024-03-0114111610.1186/s13561-024-00500-yInsurance barriers and inequalities in health care access: evidence from dual practiceEva Goetjes0Katharina E. Blankart1 CINCH Health Economics Research Center, University of Duisburg-Essen CINCH Health Economics Research Center, University of Duisburg-EssenAbstract 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.https://doi.org/10.1186/s13561-024-00500-yPhysician treatment styleHealth insurancePractice compositionEquity of care |
spellingShingle | Eva Goetjes Katharina E. Blankart Insurance barriers and inequalities in health care access: evidence from dual practice Health Economics Review Physician treatment style Health insurance Practice composition Equity of care |
title | Insurance barriers and inequalities in health care access: evidence from dual practice |
title_full | Insurance barriers and inequalities in health care access: evidence from dual practice |
title_fullStr | Insurance barriers and inequalities in health care access: evidence from dual practice |
title_full_unstemmed | Insurance barriers and inequalities in health care access: evidence from dual practice |
title_short | Insurance barriers and inequalities in health care access: evidence from dual practice |
title_sort | insurance barriers and inequalities in health care access evidence from dual practice |
topic | Physician treatment style Health insurance Practice composition Equity of care |
url | https://doi.org/10.1186/s13561-024-00500-y |
work_keys_str_mv | AT evagoetjes insurancebarriersandinequalitiesinhealthcareaccessevidencefromdualpractice AT katharinaeblankart insurancebarriersandinequalitiesinhealthcareaccessevidencefromdualpractice |