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Differences in access points to the ambulatory health care system across Austrian federal states

Deutlich unterschiedliche Zugangswege zum Gesundheitssystem im ambulantenn Sektor zwischen den österreischischen Bundesländern feststellbar

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Summary

Background

The nine Austrian regions differ according to demographic parameter, health status, and health care structure. It was the aim of this study to analyse whether there are also differences in access points towards the level of ambulatory care.

Method

The Austrian Health Interview Survey (2006–2007) data with 15,474 participants were used for this cross-sectional analysis. Statistical analyses included descriptive statistics as well as multivariate logistic regression models and correlations.

Results

There were significant differences in patients with direct utilisation of specialists without having consulted a general practitioner (GP) in the same period in the Austrian regions, with highest proportions for women in Vorarlberg (20.3 %) and men in Vienna (21.5 %) and lowest in Burgenland (7.0 and 6.6 %, respectively). The specialist/GP ratio correlated significantly with the direct specialist utilisation (Spearman correlation coefficient: 0.717).

Conclusion

There are spatial differences in the health care utilisation within the Austrian regions, which partly can be explained by the disposal of health care structure. These findings are of special importance according to the ongoing debate concerning the topic strengthening the primary health care sector in Austria.

Zusammenfassung

Hintergrund

Die neun österreichischen Bundesländer unterscheiden sich hinsichtlich demographischer Parameter, dem Gesundheitsstatus und der Organisation des Gesundheitsversorgungssystems. Es war das Ziel dieser Studie herauszufinden, ob es auch Unterschiede hinsichtlich der Inanspruchnahme des ambulanten Gesundheitssektors gibt.

Methodik

Für diese Querschnittsanalyse konnte die Datenbank der Österreichischen Gesundheitserhebung 2006–2007 mit Daten von 15.474 TeilnehmerInnen genutzt werden. Die statistische Analyse umfasste deskriptive Methoden, multivariate Regressions-Modelle und Korrelationen.

Ergebnisse

Es konnten signifikante Unterschiede in der Inanspruchnahme von FachärztInnen ohne vorherigen HausärztInnenkontakt gefunden werden. Für Frauen war die Inanspruchnahme am höchsten in Vorarlberg (20,3 %) und für Männer in Wien (21,5 %), am niedrigsten im Burgenland (F 7,0 %, M 6,6 %). Die Facharzt/Hausazt­quote des jeweiligen Bundeslandes korrelierte mit der direkten Inanspruchnahme (Spearman Korrelationskoeffizient: 0,717).

Schlussfolgerung

Unterschiede in der Inanspruchnahme des ambulanten Gesundheitssektors können quer durch Österreich gefunden werden, welche zum Teil durch die unterschiedlich organisierte Struktur des Sektors erklärt werden können. Diese Ergebnisse sind von besonderer Relevanz im Hinblick auf die österreichische Diskussion hinsichtlich der Stärkung des Primärversorgungssektors.

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Notes

  1. It was not possible to build the variable EU28 countries which would be correct since the 1st of July 2013 because of preclustered data in the original database.

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Authors and Affiliations

  1. Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1st floor, 1090, Vienna, Austria

    Kathryn Hoffmann MD, MPH

  2. Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria

    Katharina Viktoria Stein PhD & Thomas Ernst Dorner MD, MPH

Authors
  1. Kathryn Hoffmann MD, MPH
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  2. Katharina Viktoria Stein PhD
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  3. Thomas Ernst Dorner MD, MPH
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Correspondence to Kathryn Hoffmann MD, MPH.

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Hoffmann, K., Stein, K. & Dorner, T. Differences in access points to the ambulatory health care system across Austrian federal states. Wien Med Wochenschr 164, 152–159 (2014). https://doi.org/10.1007/s10354-014-0267-z

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