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COVID-19 pandemic and waiting times in outpatient specialist care in Germany: an empirical analysis.
Muschol, Jennifer; Gissel, Christian.
  • Muschol J; Department of Health Economics, Justus Liebig University, Giessen, Germany.
  • Gissel C; Department of Health Economics, Justus Liebig University, Giessen, Germany. cg@phec.de.
BMC Health Serv Res ; 21(1): 1076, 2021 Oct 11.
Article in English | MEDLINE | ID: covidwho-1463251
ABSTRACT

BACKGROUND:

International healthcare systems face the challenge that waiting times may create barriers to accessing medical care, and that those barriers are unequally distributed between different patient groups. The disruption of healthcare systems caused by the COVID-19 pandemic could exacerbate this already strained demand situation. Using the German healthcare system as an example, this study aims to analyze potential effects of the COVID-19 pandemic on waiting times for outpatient specialist care and to evaluate differences between individual patient groups based on their respective insurance status and the level of supply.

METHODS:

We conducted an experiment in which we requested appointments by telephone for different insurance statuses in regions with varying levels of supply from 908 outpatient specialist practices in Germany before and during the COVID-19 pandemic. Data from 589 collected appointments were analyzed using a linear mixed effect model.

RESULTS:

The data analysis revealed two main counteracting effects. First, the average waiting time has decreased for both patients with statutory (mandatory public health insurance) and private health insurance. Inequalities in access to healthcare, however, remained and were based on patients' insurance status and the regional level of supply. Second, the probability of not receiving an appointment at all significantly increased during the pandemic.

CONCLUSIONS:

Patient uncertainty due to the fear of a potential COVID-19 infection may have freed up capacities in physicians' practices, resulting in a reduction of waiting times. At the same time, the exceptional situation caused by the pandemic may have led to uncertainty among physicians, who might thus have allocated appointments less frequently. To avoid worse health outcomes in the long term due to a lack of physician visits, policymakers and healthcare providers should focus more on regular care in the current COVID-19 pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Waiting Lists / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: BMC Health Serv Res Journal subject: Health Services Research Year: 2021 Document Type: Article Affiliation country: S12913-021-07094-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Waiting Lists / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: BMC Health Serv Res Journal subject: Health Services Research Year: 2021 Document Type: Article Affiliation country: S12913-021-07094-9