title: [Do gatekeeping programs increase equality of health care in Germany? A comparison of the health care situation of participants and nonparticipants].
abstract: This article compares the health care situation of participants in programs of general practitioner-centered health care (gatekeeping) in Germany (participants) with that of statutory health insurance holders who are not participating in such programs (nonparticipants). Because a key objective of the general practitioner model is to reduce the number of visits to specialists, the article also examines factors influencing frequent utilization of specialists in both groups. The analysis draws on a survey conducted by the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung, 2010) based on a sample representative of the German population. In this context, 5,232 holders of statutory health insurance aged between 18 and 79 years were interviewed on health care policy issues. The results show that regulating the utilization of specialists through the gatekeeping function of general practitioners succeeds in facilitating similar utilization rates across educational levels, between cities and towns, and between men and women. Thus, gatekeeping programs contribute to the reduction of health care inequalities.
authors.affiliation: Institut für Medizinische Soziologie, Charité-Universitätsmedizin Berlin, Luisenstrasse 57, Berlin, Germany. susanne.schnitzer@charite.de
authors.forename: S
authors.initials: S
authors.lastname: Schnitzer
authors.forename: K
authors.initials: K
authors.lastname: Balke
authors.forename: A
authors.initials: A
authors.lastname: Walter
authors.forename: A
authors.initials: A
authors.lastname: Litschel
authors.forename: A
authors.initials: A
authors.lastname: Kuhlmey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005194:Family Practice / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006301:Health Services Needs and Demand / Q000458:organization & administration; D006302:Health Services Research / Q000458:organization & administration / Q000706:statistics & numerical data; D006299:Health Services for the Aged / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008511:Medicine / Q000458:organization & administration / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration* / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult