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Socioeconomic Status and the Utilization of Health Services in Germany: A Systematic Review

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Health Care Utilization in Germany

Abstract

Background

Social inequalities in health care utilization are used as a potential explanatory factor for the social gradient in morbidity and mortality. The associations between socioeconomic factors and the usage of health services were documented several times but often discussed in an undifferentiated way in Germany. Therefore, this review distinguishes between three areas of health care (inpatient care, outpatient care, and prevention). The socioeconomic status (SES) includes the established vertical status indicators (education, income, and occupational status) and the insurance status.

Methods

A systematic literature search in the PubMed database was conducted to identify relevant studies between 1998 and 2012. The studies were classified by the above-described categories of health services.

Results

The screening reveals a total of 57 studies meeting the criteria. Regarding outpatient care, the results suggest more specialist visits among people with higher SES while the few studies examining inpatient care do hardly indicate social disparities. The most publications and major inequalities could be found in the area of prevention, especially concerning cancer screening and early detection check-up in children and adolescents.

Conclusions

Social inequalities in the utilization of health services differ by health care sector. To take account of socioeconomic factors in terms of health care utilization can contribute to a reduction of health inequalities.

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Authors and Affiliations

  1. Center for Psychosocial Medicine, Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Jens Klein, Kerstin Hofreuter-GÃĪtgens & Olaf von dem Knesebeck

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  1. Jens Klein
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  2. Kerstin Hofreuter-GÃĪtgens
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  3. Olaf von dem Knesebeck
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Correspondence to Jens Klein .

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Editors and Affiliations

  1. Department of Applied Social Sciences, Munich University of Applied Sciences, Munich, Germany

    Christian Janssen

  2. Institute of Social Medicine & Health Economics, Otto von Guericke University Magdeburg, City, Germany

    Enno Swart

  3. Ctr of Public Health & Health Care, Medical Psych. Unit, Hannover Medical School, Hannover, Germany

    Thomas von Lengerke

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Klein, J., Hofreuter-GÃĪtgens, K., von dem Knesebeck, O. (2014). Socioeconomic Status and the Utilization of Health Services in Germany: A Systematic Review. In: Janssen, C., Swart, E., von Lengerke, T. (eds) Health Care Utilization in Germany. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9191-0_8

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