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Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review

BACKGROUND: Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult populati...

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Autores principales: Lueckmann, Sara Lena, Hoebel, Jens, Roick, Julia, Markert, Jenny, Spallek, Jacob, von dem Knesebeck, Olaf, Richter, Matthias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874661/
https://www.ncbi.nlm.nih.gov/pubmed/33568126
http://dx.doi.org/10.1186/s12939-020-01375-1
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author Lueckmann, Sara Lena
Hoebel, Jens
Roick, Julia
Markert, Jenny
Spallek, Jacob
von dem Knesebeck, Olaf
Richter, Matthias
author_facet Lueckmann, Sara Lena
Hoebel, Jens
Roick, Julia
Markert, Jenny
Spallek, Jacob
von dem Knesebeck, Olaf
Richter, Matthias
author_sort Lueckmann, Sara Lena
collection PubMed
description BACKGROUND: Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. METHODS: We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. RESULTS: Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. CONCLUSION: This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare. PROSPERO REGISTRATION NUMBER: CRD42019123222. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12939-020-01375-1.
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spelling pubmed-78746612021-02-11 Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review Lueckmann, Sara Lena Hoebel, Jens Roick, Julia Markert, Jenny Spallek, Jacob von dem Knesebeck, Olaf Richter, Matthias Int J Equity Health Systematic Review BACKGROUND: Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. METHODS: We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. RESULTS: Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. CONCLUSION: This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare. PROSPERO REGISTRATION NUMBER: CRD42019123222. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12939-020-01375-1. BioMed Central 2021-02-10 /pmc/articles/PMC7874661/ /pubmed/33568126 http://dx.doi.org/10.1186/s12939-020-01375-1 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Systematic Review
Lueckmann, Sara Lena
Hoebel, Jens
Roick, Julia
Markert, Jenny
Spallek, Jacob
von dem Knesebeck, Olaf
Richter, Matthias
Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review
title Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review
title_full Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review
title_fullStr Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review
title_full_unstemmed Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review
title_short Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review
title_sort socioeconomic inequalities in primary-care and specialist physician visits: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874661/
https://www.ncbi.nlm.nih.gov/pubmed/33568126
http://dx.doi.org/10.1186/s12939-020-01375-1
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