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Wachtler B, Beese F, Demirer I, Haller S, Pförtner TK, Wahrendorf M, Grabka MM, Hoebel J. Education and pandemic SARS-CoV-2 infections in the German working population - the mediating role of working from home. Scand J Work Environ Health 2024; 50:168-177. [PMID: 38346224 PMCID: PMC11064849 DOI: 10.5271/sjweh.4144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Indexed: 03/28/2024] Open
Abstract
OBJECTIVES SARS-CoV-2 infections were unequally distributed during the pandemic, with those in disadvantaged socioeconomic positions being at higher risk. Little is known about the underlying mechanism of this association. This study assessed to what extent educational differences in SARS-CoV-2 infections were mediated by working from home. METHODS We used data of the German working population derived from the seroepidemiological study "Corona Monitoring Nationwide - Wave 2 (RKI-SOEP-2)" (N=6826). Infections were assessed by seropositivity against SARS-CoV-2 antigens and self-reports of previous PCR-confirmed infections from the beginning of the pandemic until study participation (November 2021 - February 2022). The frequency of working from home was assessed between May 2021 and January 2022.We used the Karlson-Holm-Breen (KHB) method to decompose the effect of education on SARS-CoV-2 infections. RESULTS Individuals with lower educational attainment had a higher risk for SARS-CoV-2 infection (adjusted prevalence ratio of low versus very high = 1.76, 95% confidence interval 1.08-2.88; P=0.023). Depending on the level of education, between 27% (high education) and 58% (low education) of the differences in infection were mediated by the frequency of working from home. CONCLUSIONS Working from home could prevent SARS-CoV-2 infections and contribute to the explanation of socioeconomic inequalities in infection risks. Wherever possible, additional capacities to work remotely, particularly for occupations that require lower educational attainment, should be considered as an important measure of pandemic preparedness. Limitations of this study are the observational cross-sectional design and that the temporal order between infection and working from home remained unclear.
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Affiliation(s)
- Benjamin Wachtler
- ORCID ID 0000-0002-3959-5676, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany.
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Bartig S, Beese F, Wachtler B, Grabka MM, Mercuri E, Schmid L, Schmid-Küpke NK, Schranz M, Goßner L, Niehues W, Zinn S, Poethko-Müller C, Schaade L, Hövener C, Gößwald A, Hoebel J. Socioeconomic Differences in SARS-CoV-2 Infection and Vaccination in Germany: A Seroepidemiological Study After One Year of COVID-19 Vaccination Campaign. Int J Public Health 2023; 68:1606152. [PMID: 37780135 PMCID: PMC10538434 DOI: 10.3389/ijph.2023.1606152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/04/2023] [Indexed: 10/03/2023] Open
Abstract
Objective: To evaluate the socioeconomic patterns of SARS-CoV-2 antigen contacts through infection, vaccination or both ("hybrid immunity") after 1 year of vaccination campaign. Methods: Data were derived from the German seroepidemiological Corona Monitoring Nationwide study (RKI-SOEP-2; n = 10,448; November 2021-February 2022). Combining serological and self-report data, we estimated adjusted prevalence ratios (PR) of SARS-CoV-2 infection, COVID-19 vaccination, basic immunization (at least two SARS-CoV-2 antigen contacts through vaccination and/or infection), and three antigen contacts by education and income. Results: Low-education groups had 1.35-times (95% CI 1.01-1.82) the risk of SARS-CoV-2 infection compared to high-education groups. COVID-19 vaccination (at least one dose) and basic immunization decreased with lower education and income. Low-education and low-income groups were less likely to have had at least three antigen contacts (PR low vs. high education: 0.74, 95% CI 0.65-0.84; PR low vs. high income: 0.66, 95% CI 0.57-0.77). Conclusion: The results suggest a lower level of protection against severe COVID-19 for individuals from low and medium socioeconomic groups. Pandemic response and vaccination campaigns should address the specific needs and barriers of these groups.
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Affiliation(s)
- Susanne Bartig
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Florian Beese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Markus M. Grabka
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | - Elisabetta Mercuri
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Lorenz Schmid
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Madlen Schranz
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Laura Goßner
- Institute for Employment Research (IAB), Nuremberg, Germany
| | - Wenke Niehues
- Research Centre of the Federal Office for Migration and Refugees (BAMF-FZ), Nuremberg, Germany
| | - Sabine Zinn
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | | | - Lars Schaade
- Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Claudia Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Antje Gößwald
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Hoebel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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3
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Neuhauser H, Rosario AS, Butschalowsky H, Haller S, Hoebel J, Michel J, Nitsche A, Poethko-Müller C, Prütz F, Schlaud M, Steinhauer HW, Wilking H, Wieler LH, Schaade L, Liebig S, Gößwald A, Grabka MM, Zinn S, Ziese T. Nationally representative results on SARS-CoV-2 seroprevalence and testing in Germany at the end of 2020. Sci Rep 2022; 12:19492. [PMID: 36376417 PMCID: PMC9662125 DOI: 10.1038/s41598-022-23821-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Pre-vaccine SARS-CoV-2 seroprevalence data from Germany are scarce outside hotspots, and socioeconomic disparities remained largely unexplored. The nationwide representative RKI-SOEP study (15,122 participants, 18-99 years, 54% women) investigated seroprevalence and testing in a supplementary wave of the Socio-Economic-Panel conducted predominantly in October-November 2020. Self-collected oral-nasal swabs were PCR-positive in 0.4% and Euroimmun anti-SARS-CoV-2-S1-IgG ELISA from dry-capillary-blood antibody-positive in 1.3% (95% CI 0.9-1.7%, population-weighted, corrected for sensitivity = 0.811, specificity = 0.997). Seroprevalence was 1.7% (95% CI 1.2-2.3%) when additionally correcting for antibody decay. Overall infection prevalence including self-reports was 2.1%. We estimate 45% (95% CI 21-60%) undetected cases and lower detection in socioeconomically deprived districts. Prior SARS-CoV-2 testing was reported by 18% from the lower educational group vs. 25% and 26% from the medium and high educational group (p < 0.001, global test over three categories). Symptom-triggered test frequency was similar across educational groups. Routine testing was more common in low-educated adults, whereas travel-related testing and testing after contact with infected persons was more common in highly educated groups. This countrywide very low pre-vaccine seroprevalence in Germany at the end of 2020 can serve to evaluate the containment strategy. Our findings on social disparities indicate improvement potential in pandemic planning for people in socially disadvantaged circumstances.
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Affiliation(s)
- Hannelore Neuhauser
- Robert Koch Institute, Berlin, Germany.
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany.
| | | | | | | | | | | | | | | | | | | | - Hans W Steinhauer
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | | | | | | | - Stefan Liebig
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
- SOEP & Department of Political and Social Sciences, Free University, Berlin, Germany
| | | | - Markus M Grabka
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | - Sabine Zinn
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
- SOEP & Department of Social Sciences, Humboldt University, Berlin, Germany
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4
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Wachtler B, Neuhauser H, Haller S, Grabka MM, Zinn S, Schaade L, Hövener C, Hoebel J. The Risk of Infection with SARS-CoV-2 Among Healthcare Workers During the Pandemic. Dtsch Arztebl Int 2021; 118:842-843. [PMID: 35264284 DOI: 10.3238/arztebl.m2021.0376] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 09/16/2021] [Accepted: 09/16/2021] [Indexed: 12/20/2022]
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5
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Hoebel J, Grabka MM, Schröder C, Haller S, Neuhauser H, Wachtler B, Schaade L, Liebig S, Hövener C, Zinn S. Socioeconomic position and SARS-CoV-2 infections: seroepidemiological findings from a German nationwide dynamic cohort. J Epidemiol Community Health 2021; 76:350-353. [PMID: 34583961 PMCID: PMC8921578 DOI: 10.1136/jech-2021-217653] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/16/2021] [Indexed: 11/11/2022]
Abstract
Background Evidence on the relationship between socioeconomic position (SEP) and infections with SARS-CoV-2 is still limited as most of the available studies are ecological in nature. This is the first German nationwide study to examine differences in the risk of SARS-CoV-2 infections according to SEP at the individual level. Methods The ‘CORONA-MONITORING bundesweit’ (RKI-SOEP) study is a seroepidemiological survey among a dynamic cohort of the German adult population (n=15 122; October 2020–February 2021). Dried blood samples were tested for SARS-CoV-2 antibodies and oral-nasal swabs for viral RNA. SEP was measured by education and income. Robust logistic regression was used to examine adjusted associations of SARS-CoV-2 infections with SEP. Results 288 participants were seropositive, PCR positive or self-reported a previous laboratory-confirmed SARS-CoV-2 infection. The adjusted odds of SARS-CoV-2 infection were 1.87-fold (95% CI 1.06 to 3.29) higher among low-educated than highly educated adults. Evidence was weaker for income differences in infections (OR=1.65; 95% CI 0.89 to 3.05). Highly educated adults had lower odds of undetected infection. Conclusion The results indicate an increased risk of SARS-CoV-2 infection in low-educated groups. To promote health equity in the pandemic and beyond, social determinants should be addressed more in infection protection and pandemic planning.
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Affiliation(s)
- Jens Hoebel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Markus M Grabka
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | - Carsten Schröder
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany.,School of Business and Economics, Freie Universität Berlin, Berlin, Germany
| | - Sebastian Haller
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Hannelore Neuhauser
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Lars Schaade
- Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Stefan Liebig
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | - Claudia Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Sabine Zinn
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany.,Departement of Social Sciences, Humboldt University, Berlin, Germany
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6
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Kuhn U, Grabka MM, Suter C. Early retirement as a privilege for the rich? A comparative analysis of Germany and Switzerland. Adv Life Course Res 2021; 47:100392. [PMID: 36695149 DOI: 10.1016/j.alcr.2020.100392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 10/17/2020] [Accepted: 11/24/2020] [Indexed: 06/17/2023]
Abstract
This contribution analyses early retirement in Germany and Switzerland with a focus on financial resources. Using data from CH-SILC linked to administrative records and the German SOEP, we distinguish three different financial resources: namely, pre-retirement labour income, net worth and pension entitlements. High labour income reduces the probability for early retirement. In contrast, high pension entitlements are associated with early retirement. Private wealth also plays an important role in early retirement, but differs with regard to the relevance of the asset components between the two countries. Although the pension system moderates the influence of financial resources on retirement behaviour, the direction of the effects is consistent across the countries once pension entitlements are accounted for.
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7
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Hoebel J, Busch MA, Grabka MM, Zinn S, Allen J, Göfêwald A, Wernitz J, Goebel J, Steinhauer HW, Siegers R, Schroder C, Kuttig T, Butschalowsky H, Schlaud M, Rosario AS, Brix J, Rysina A, Glemser A, Neuhauser H, Stahlberg S, Kneuer A, Hey I, Schaarschmidt J, Fiebig J, Buttmann-Schweiger N, Wilking H, Michel J, Nitsche A, Wieler LH, Schaade L, Ziese T, Liebig S, Lampert T. Seroepidemiological study on the spread of SARS-CoV-2 in Germany: Study protocol of the CORONA-MONITORING bundesweit' study (RKI-SOEP study). J Health Monit 2021; 6:2-16. [PMID: 35585914 PMCID: PMC8832365 DOI: 10.25646/7853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/20/2021] [Indexed: 01/29/2023]
Abstract
The SARS-CoV-2 coronavirus has spread rapidly across Germany. Infections are likely to be under-recorded in the notification data from local health authorities on laboratory-confirmed cases since SARS-CoV-2 infections can proceed with few symptoms and then often remain undetected. Seroepidemiological studies allow the estimation of the proportion in the population that has been infected with SARS-CoV-2 (seroprevalence) as well as the extent of undetected infections. The ‘CORONA-MONITORING bundesweit’ study (RKI-SOEP study) collects biospecimens and interview data in a nationwide population sample drawn from the German Socio-Economic Panel (SOEP). Participants are sent materials to self-collect a dry blood sample of capillary blood from their finger and a swab sample from their mouth and nose, as well as a questionnaire. The samples returned are tested for SARS-CoV-2 IgG antibodies and SARS-CoV-2 RNA to identify past or present infections. The methods applied enable the identification of SARS-CoV-2 infections, including those that previously went undetected. In addition, by linking the data collected with available SOEP data, the study has the potential to investigate social and health-related differences in infection status. Thus, the study contributes to an improved understanding of the extent of the epidemic in Germany, as well as identification of target groups for infection protection.
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Affiliation(s)
- Jens Hoebel
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Markus A Busch
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Markus M Grabka
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | - Sabine Zinn
- German Institute for Economic Research, Berlin, Socio-Economic Panel.,Humboldt University Berlin Faculty of Humanities and Social Sciences
| | - Jennifer Allen
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Antje Göfêwald
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jörg Wernitz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jan Goebel
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | | | - Rainer Siegers
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | - Carsten Schroder
- German Institute for Economic Research, Berlin, Socio-Economic Panel.,Freie Universität Berlin School of Business and Economics
| | - Tim Kuttig
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Hans Butschalowsky
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Martin Schlaud
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | | | | | | | - Hannelore Neuhauser
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Silke Stahlberg
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Antje Kneuer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Isabell Hey
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jörg Schaarschmidt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Julia Fiebig
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | - Hendrik Wilking
- Robert Koch Institute, Berlin Department of Infectious Disease Epidemiology
| | - Janine Michel
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens
| | - Andreas Nitsche
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens
| | - Lothar H Wieler
- Robert Koch Institute, Berlin Institute Leadership.,Robert Koch Institute, Berlin Methodology and Research Infrastructure
| | - Lars Schaade
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens.,Robert Koch Institute, Berlin Institute Leadership
| | - Thomas Ziese
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Stefan Liebig
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | - Thomas Lampert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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8
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Leckelt M, Richter D, Schröder C, Küfner ACP, Grabka MM, Back MD. The rich
are
different: Unravelling the perceived and self‐reported personality profiles of high‐net‐worth individuals. Br J Psychol 2018; 110:769-789. [DOI: 10.1111/bjop.12360] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 10/16/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Marius Leckelt
- Department of Psychology University of Münster Germany
- Department of Psychology University of Mainz Germany
| | - David Richter
- German Institute for Economic Research/SOEP Berlin Germany
| | - Carsten Schröder
- German Institute for Economic Research/SOEP Berlin Germany
- Department of Economics Free University of Berlin Germany
| | | | | | - Mitja D. Back
- Department of Psychology University of Münster Germany
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9
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Bönke T, Faik J, Grabka MM. Tragen ältere Menschen ein erhöhtes Armutsrisiko? Eine Dekompositions- und Mobilitätsanalyse relativer Einkommensarmut für das wiedervereinigte Deutschland. ACTA ACUST UNITED AC 2016. [DOI: 10.1515/zsr-2012-0205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In diesem Beitrag wird die Entwicklung relativer Einkommensaltersarmut seit der deutschen Wiedervereinigung bis zum Jahr 2010 untersucht. Dies geschieht sowohl in Quer- als auch in Längsschnittperspektive. Die Ergebnisse der Analysen geigen, dass das Altersarmutsrisiko in Deutschland inzwischen geringer ist als andere Armutsrisiken – etwa als jenes der jüngsten Altersgruppen. Allerdings ist seit 2007 auch das relative Altersarmutsrisiko wieder gewachsen, und zwar weitgehend parallel zur allgemeinen Armutsrisikoerhöhung. Hinzu kommt seitdem ein Anstieg der Wahrscheinlichkeit, in Altersarmut zu verbleiben.
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Affiliation(s)
- Timm Bönke
- Freie Universität Berlin Boltzmannstraße 20 14195 Berlin
| | - Jürgen Faik
- FaMa – Neue Frankfurter Sozialforschung & HS Darmstadt Nikolausstraße 10 65936 Frankfurt am Main
| | - Markus M. Grabka
- Deutsches Institut für Wirtschaftsforschung & Technische Universität Berlin Mohrenstraße 58 10117 Berlin
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11
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Schreyögg J, Grabka MM. Copayments for ambulatory care in Germany: a natural experiment using a difference-in-difference approach. Eur J Health Econ 2010; 11:331-341. [PMID: 19756797 DOI: 10.1007/s10198-009-0179-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Accepted: 08/04/2009] [Indexed: 05/28/2023]
Abstract
In response to increasing health expenditures and a high number of physician visits, the German government introduced a copayment for ambulatory care in 2004 for individuals with statutory health insurance (SHI). Because persons with private insurance were exempt from the copayments, this health-care reform can be regarded as a natural experiment. We used a difference-in-difference approach to examine whether the new copayment effectively reduced the overall demand for physician visits and to explore whether it acted as a deterrent to vulnerable groups, such as those with low income or chronic conditions. We found that there was no significant reduction in the number of physician visits among SHI members compared to our control group. At the same time, we did not observe a deterrent effect among vulnerable individuals. Thus, the copayment has failed to reduce the demand for physician visits. It is likely that this result is due to the design of the copayment scheme, as the copayment is low and is paid only for the first physician visit per quarter.
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Affiliation(s)
- Jonas Schreyögg
- Department for Health Services Management, Munich School of Management, LMU Munich, Schackstr. 4, 80539, Munich, Germany.
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13
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Goebel J, Grabka MM, Krause P, Kroh M, Pischner R, Sieber I, Spieß M. Mikrodaten, Gewichtung und Datenstruktur der Längsschnittstudie Sozio-oekonomisches Panel (SOEP). ACTA ACUST UNITED AC 2008. [DOI: 10.3790/vjh.77.3.77] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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14
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Anger S, Frick JR, Goebel J, Grabka MM, Groh-Samberg O, Haas H, Holst E, Krause P, Kroh M, Lohmann H, Pischner R, Schupp J, Sieber I, Siedler T, Schmitt C, Spieß CK, Spieß M, Tucci I, Wagner GG. Zur Weiterentwicklung von SOEPsurvey und SOEPservice. ACTA ACUST UNITED AC 2008. [DOI: 10.3790/vjh.77.3.157] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Grabka MM, Schreyögg J, Busse R. Verhaltensänderung durch Einführung der Praxisgebühr und Ursachenforschung. ACTA ACUST UNITED AC 2006; 101:476-83. [PMID: 16767571 DOI: 10.1007/s00063-006-1067-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2005] [Revised: 02/14/2006] [Indexed: 10/24/2022]
Abstract
As part of the Statutory Health Insurance Modernization Act a co-payment of 10 Euros per quarter for the first contact at a physician's or a dentist's office has been introduced with effect of January 1, 2004. Apart from contributing to the financial consolidation of the Statutory Health Insurance the co-payment aimed at changing the patients' behavior toward more self-responsibility. This article shows that physician contacts declined in the year 2004 compared to 2003. However, the share of those patients who had at least one physician contact in both years remained stable. Two Logit models point out that necessary physician contacts still take place, e. g., in case of disabled persons and persons with poor health. In addition, no discrimination of persons of low social status could be observed. The results are also approved by other studies. Therefore, it seems plausible, that the introduction of this co-payment has contributed to a reduction of unnecessary and redundant physician visits.
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Affiliation(s)
- Markus M Grabka
- Deutsches Institut für Wirtschaftsforschung (DIW), Längsschnittstudie Sozio-oekonomisches Panel, Berlin
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