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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 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 visitingBackground 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.show moreshow less

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Author: Sara Lena Lueckmann, Jens Hoebel, Julia Roick, Jenny Markert, Jacob SpallekORCiDGND, Olaf von dem Knesebeck, Matthias Richter
DOI:https://doi.org/10.1186/s12939-020-01375-1
ISSN:1475-9276
Title of the source (English):International journal for equity in health
Document Type:Scientific journal article peer-reviewed
Language:English
Year of publication:2021
Tag:Socioeconomic inequalities; primary-care; specialist physician; systematic review
Volume/Year:20
Number of pages:19
Article number:58
Faculty/Chair:Fakultät 4 Humanwissenschaften (bis 2023 Soziale Arbeit, Gesundheit und Musik) / FG Gesundheitswissenschaften
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