Luque Ramos, Andres and Hoffmann, Falk and Spreckelsen, Ove
(2018)
Waiting times in primary care depending on insurance scheme in Germany.
BMC Health Services Research, 18 (1).
ISSN 1472-6963
Abstract
Background: Waiting times for an outpatient appointment in Germany differ between insurants of the statutory and
private health insurance schemes, especially for specialised care. The aim of this study was to uncover possible differences
in waiting times depending on health insurance scheme and to identify predictors for excessive waiting times
in primary care.
Methods: We used data of the Bertelsmann Foundation Healthcare Monitor, which is a repeated cross sectional study
dealing with experiences in health care and attitudes towards current health policy themes. We analysed the surveys
conducted from 2011 to 2013, with respondents assigned to their health insurance fund, namely AOK, BARMER GEK,
BKK, DAK, TK, IKK, other statutory funds and private funds. The mean waiting times for an appointment and spent in
a physician’s waiting room, and the satisfaction with waiting times were evaluated with respect to different health
insurance funds. A logistic regression model was used to calculate the chance of excessive waiting times with respect
to health insurance fund, age, sex, health and socioeconomic status. The ninetieth percentile of the waiting time distribution
(10 days) was chosen as the cut-off point between average and excessive.
Results: A total of 5618 respondents were analysed. Mean waiting times in primary care were low (4.0 days)
and homogeneous (SHIs: 3.6–4.9 days), even though privately insured respondents reported shorter waiting
times for appointments (3.3 days). They also reported a greater satisfaction with waiting times (77.5%) than
SHI insurants (64.5%). However, we identified a group (10.1%), who experienced excessive waiting times in
primary care. Compared to privately insured respondents, the chance of excessive waiting times was increased for SHI
insurants (highest odds ratio for BKK: 2.17; 95%-CI: 1.38–3.42). Additionally, higher age and residence in East Germany
were associated with higher chances of waiting times of 10 days or more.
Conclusions: Primary care in Germany is readily accessible with generally short waiting times. However, barriers in access
to the health care system affect a certain part of patients depending on insurance status, age and region of residence.
Ways to improve the access need to be studied.
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