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The following is a summary of “Social disparities in access and quality of consultation in outpatient care in Germany,” published in the August 2024 issue of Primary Care by Knesebeck et al.

While this study is a significant step forward, it’s important to note that research on social determinants affecting access to and the quality of outpatient care in Germany is still in its early stages. This study, which investigates the disparities in perceived access and consultation quality across different social groups, including sex, age, income, migration background, and health insurance status, within the context of primary and specialist care, highlights the need for further research.

The study utilized data from a cross-sectional online survey, drawing a random sample of 2,201 adults from a population panel recruited offline. Perceived access was evaluated by measuring appointment waiting times (in days) and travel times to the practice (in minutes). The quality of consultation was assessed through consultation duration (in minutes), and the quality of communication was measured on a four-item scale with a Cronbach’s Alpha of 0.89.

The findings indicate significant social disparities in both primary and specialist outpatient care. Women reported worse access and consultation quality in primary care compared to men. Statutory health insurance holders experienced shorter consultation times than those with private insurance. For specialist care, individuals aged 60 and older reported shorter waiting times and better communication quality. Conversely, lower-income groups and those with statutory health insurance reported poorer communication quality and overall access. The variance explained by these social factors ranged between 1% and 4% for access and 3% and 7% for consultation quality.

The study’s findings reveal significant social disparities in Germany’s perceived access to and quality outpatient care. These disparities suggest the presence of structural and interpersonal discrimination within the healthcare system. The implications are clear: Addressing these disparities is not just important; it’s crucial for improving equitable access and quality of care across all social groups.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02552-9