Hajek André, König Hans-Helmut
Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany.
Healthcare (Basel). 2022 Jun 1;10(6):1025. doi: 10.3390/healthcare10061025.
The goal of this study was to investigate the determinants of outpatient physician visits in Germany during the later stages of the COVID-19 pandemic. Cross-sectional data were used from the general adult population in Germany with = 3091 individuals (data collection in mid-March 2022). Determinants were selected based on the extended Andersen model. The number of GP visits as well as the number of specialist visits in the past 12 months were used as outcome measures. Negative binomial regressions showed that the number of GP visits was positively associated with a lower educational level, being retired, lower levels of loneliness, the presence of at least one chronic condition, lower self-rated health, being vaccinated against COVID-19, and the presence of depression. Moreover, negative binomial regressions showed that the number of specialist visits was positively associated with being female, a lower age, having children, being married, not being full-time employed, the presence of at least one chronic condition, lower self-rated health, the presence of depression, being vaccinated against COVID-19 and having a lower coronavirus anxiety. In conclusion, while our study showed that need factors are still a main driver of outpatient physician visits, our findings additionally showed that predisposing characteristics, enabling resources and psychosocial factors are also important for the number of outpatient physician visits in Germany during the COVID-19 pandemic. Knowledge about these determinants (e.g., vaccination status, loneliness or coronavirus anxiety) is also important to avoid under- or overuse of the healthcare system.
本研究的目的是调查在新冠疫情后期德国门诊就医的决定因素。我们使用了来自德国成年普通人群的横断面数据,样本量为3091人(数据收集于2022年3月中旬)。决定因素是根据扩展的安德森模型选取的。过去12个月内全科医生就诊次数以及专科医生就诊次数被用作结果指标。负二项回归分析表明,全科医生就诊次数与较低的教育水平、退休状态、较低的孤独感、至少患有一种慢性病、较低的自评健康状况、接种新冠疫苗以及患有抑郁症呈正相关。此外,负二项回归分析表明,专科医生就诊次数与女性、较低年龄、育有子女、已婚、非全职工作、至少患有一种慢性病、较低的自评健康状况、患有抑郁症、接种新冠疫苗以及较低的新冠焦虑水平呈正相关。总之,虽然我们的研究表明需求因素仍是门诊就医的主要驱动因素,但我们的研究结果还表明,在新冠疫情期间, predisposing characteristics、促成资源和社会心理因素对德国门诊就医次数也很重要。了解这些决定因素(如疫苗接种状况、孤独感或新冠焦虑)对于避免医疗系统的使用不足或过度使用也很重要。